The CEO Revenue Enhancement Unit’s goal is to work with County departments and community partners to develop and recommend revenue maximization and leveraging strategies from a Countywide perspective, and to develop specific strategies that maintain service integrity, encourage service coordination and integration, and promote revenue maximization.
The Unit focuses on projects aimed at identifying leveraging opportunities and coordinating leveraging activities among departments and agencies, and pursuing new and existing revenue strategies from a broad based perspective.
REVENUE ENHANCEMENT PROJECTS
Medical Administrative Activities (MAA)/Targeted Case Management (TCM) Program
Purpose of the Program: Receive federal reimbursement for providing certain qualified activities targeting and improving the availability and accessibility of Medi-Cal services to Medi-Cal eligible and potentially eligible individuals and their families. Both MAA and TCM provide reimbursement for activities that are already being performed by many programs. For Los Angeles County, the Chief Executive Office (CEO) is designated as the Local Governmental Agency (LGA) and coordinates Countywide participation and administration of the MAA/TCM programs to meet State and federal requirements. The Auditor Controller (A-C) has responsibility for providing fiscal guidance and oversight.
Program Funding: Both MAA and TCM are federally funded through the federal Medicaid program. The California Department of Health Care Services (CDHCS) contracts with counties/cities to administer MAA and TCM locally. The federal government [Centers for Medicare and Medicaid Services (CMS)] reimburses a share of the cost of these programs and the local program pays part of the cost. The local share must be a Certified Public Expenditure (CPE), which is the expenditure of local public funds or other funds eligible to be used as CPE.
Medi-Cal Administrative Activities (MAA)
A CDHCS approved claiming plan is a requirement of participation in MAA and is the basis for determining allowable costs and activities for which federal reimbursement may be claimed. MAA is activity specific and pays for performing Medi-Cal related activities to individuals or groups such as:
- Medi-Cal Outreach
- Assisting individuals to apply for Medi-Cal
- Transporting Medi-Cal beneficiaries to non-emergency Medi-Cal covered services
- Improving access to and the delivery of Medi-Cal covered services.
Targeted Case Management (TCM)
TCM is client specific and pays for comprehensive case management services to assist high risk targeted populations who are current Medi-Cal beneficiaries to understand, access, use and benefit from needed medical, social, educational, and other services. An annual cost Report is required to participate in the TCM program. California’s currently approved Medi-Cal State Plan authorizes the provision of TCM in six program areas: Adult Probation, Linkages/Aging, Outpatient Clinics, Public Guardian, Public Health, and Community. TCM service components include:
- Documented Assessment
- Written, Comprehensive, Individualized Service Plan
- Linkage and Consultation
- Assistance with Accessing Services
- Crisis Assistance Planning
- Periodic Review