Medicaid Administrative Claiming (MAC)
What is MAC?
The Medicaid Administrative Claiming (MAC) Program provides reimbursement to Local Health Departments (LHDs) for administrative activities that directly support efforts to identify and enroll eligible clients into Medicaid, to bring them services covered by Medicaid, to remove barriers to accessing Medicaid services and to reduce gaps in Medicaid services.
Public Health agencies and the Medicaid Program share a focus on improving access to health care for low income Ohioans. LHDs know that a lack of health insurance, limited availability of providers, limited transportation, language barriers and the complex health care system pose challenges to many Ohioans. Through MAC a LHD can be reimbursed, in part, for their efforts that assist low income Ohioans in enrolling in Medicaid and accessing appropriate Medicaid-covered services.
Medicaid covered services are those medical, dental, and mental health services in Ohio’s Medicaid State Plan. If a LHD helps people from the community to enroll in Medicaid, or obtain a Medicaid service such as EPSDT, immunizations, family planning, BCMH, or prenatal care, it is likely the agency is doing reimbursable MAC activities.
Examples of MAC reimbursable activities would be:
- Medicaid Outreach
- Facilitating Medicaid Eligibility
- Referral, Coordination and Monitoring of Medicaid Services
- Transportation and Translation for Medicaid Services
- Medical Related Provider Relations
- Program Planning, Development & Interagency Coordination of Medical Services
LHDs are in an ideal position to identify Ohioans who are in need of health care services and all LHDs may participate. Each interested agency must enter into a contract with the Ohio Department of Health, complete an implementation plan and complete a quarterly time study to document the staff time on MAC activities. LHDs are able to receive reimbursement for up to 50% of the costs related to their MAC activities.
What is Medicaid Administrative Claiming (MAC)? is a short presentation about the MAC program.
Some additional useful information about the MAC program:
Last updated 7/23/2014