Medicaid Administrative Claiming for Local Public Health Departments

OUR VISION: Reducing Health Disparities by assuring the opportunity of eligible clients to obtain proper Medicaid Services.

The Medicaid Administrative Claiming (MAC) Program has been approved by Centers for Medicare and Medicaid Services.  MAC will provide reimbursement to Local Public Health Departments (LPHDs) for administrative activities that directly support efforts to identify and enroll potential eligible clients into Medicaid, to bring them into services covered by Medicaid, to remove barriers to accessing Medicaid services and to reduce gaps in Medicaid services.

An example of MAC reimbursable activities would be: identifying children and families who are a potential eligible or a current Medicaid eligible that are in need of Health Check and providing the assistance they need to access services. These MAC activities can include assisting potential clients through the Medicaid application process and/or linking a current Medicaid recipient to needed health care services.    

The MAC activities, which emphasize outreach to bring potential eligible clients into Medicaid and linking Medicaid eligible clients into Medicaid services are a set of activities that:

• Improves the use of Medicaid covered service or

• Improves the access to Medicaid coverage.

LPHDs are in an ideal position to identify Ohioans who are in need of health care services. LPHDs are able to receive federal reimbursement for up to 50% of the costs related to their MAC activities. 

To assist the LPHD in starting and maintaining a MAC program the Ohio Department of Health has developed a LPHD Manual for MAC.  To gain access to the Manual click below:

LPHD Manual

Manual Attachments:

A. MAC Introduction

• MAC An Introduction
• Five Implementation Phases

B.  The Six Core MAC Reimbursable Codes

C. MAC Implementation Plan, Memorandum of Agreement (MOA) and Policy Issuances

• Implementation Plan
• MOA Template
• Policy Issuances

D. Methodology Guide

E. Key MAC Dates

F. Trainers Handbook and Training Materials

• Trainers Handbook

Cover and Spine for Training Materials

• MAC Time Study Training
• MAC Table of Contents
• Parallel Coding
• Medicaid Services
• Non-Medicaid
• One Page Activity Code
• Code Descriptions 
• Verb
• Questions and Answers
• Tips for MAC
• MAC Training Glossary

G. Electronic Time Study, Percentage Summary, Excel Training, and Evaluation Tools

• Daily Documentation Log (Example) 
• Percentage Summary (Example)
• Roster DDL and Percentage Summary Directions
• Excel Time Study
• Unit, Sub-Unit, Individual Code Comparison
• Description Collection

H. Claim and Instructions

• County Claim (Example)
• Local Claim Preparation

I. MAC Glossary of Terms

Agency/Claiming Unit Code by Code Comparison

Below are current agencies/claiming units who time-studied and submitted claims.  The purpose of supplying these time-study results is for agencies to select similar agencies (size, number of participants, programs, etc.) and view actual time-study results since the MAC program was approved in July 2007.  A contact name and phone number is provided if you wish to discuss in more detail.  As new agencies submit claims their results will be added to the website. 

Columbus Public Health Code Comparison

Mansfield/Ontario/Richland Code Comparison

Mahoning Code Comparison

For more information email MAC-Administrator@odh.ohio.gov

Last updated: 04/01/08