MAC Local Health Districts (LHD)

General Information

The purpose of the Medicaid Administrative Claiming (MAC) program is to provide State affiliated public agencies such as Local Health Districts (LHD's) in Texas the opportunity to submit reimbursement claims for administrative activities that support the Medicaid program. In order for the cost to be allowable and reimbursable under Medicaid, the activities must be found to be necessary for the proper and efficient administration under the Texas Medicaid State Plan, and must adhere to applicable requirements as defined in State and Federal Law.

LHD's can be reimbursed for certain medical and health-related activities such as outreach services delivered to clients within the community, regardless of whether the client is Medicaid eligible or not, and without any impact on other similar services the patient may receive elsewhere. Outreach services may be provided to a client and/or the client's family and may include activities such as coordinating, referring, or assisting the client/family in accessing needed medical/health or mental care services.

Revenue generated from MAC claims is dedicated to the provision of health services and may be used to enhance, improve and/or expand the level and quality of health/medical services provided to clients within the community. All MAC (Medicaid Administrative Claiming) expenditures which are subject to reimbursement are Title XIX funds. The MAC reimbursements payments received from Medicaid Administrative Claims CFDA #93.778 are subject to the Single Audit Act. Therefore, the funds should be included on the SEFA (Statement of Expenditures of Federal Awards) on each entity's audited financial statements. If the MAC award is identified as a major federal program, the entity's external auditor should perform work deemed necessary to reduce risk and report the funds appropriately in accordance with OMB Circular A-133. The auditor should research all other requirements to ensure that MAC funds are appropriately audited and reported.

Additional Information

What is Medicaid Administrative Claiming for LHD's? (.pdf) (updated 04/28/2010)

Related Information

HHSC Contractor for MAC Financial reporting

Time Study

Guides / Manuals / Tutorials

MAC Financial Participation Guide (.pdf) - effective October 1, 2010

MAC Financial Guide (.pdf) - effective through September 30, 2010

MAC Video Tutorial - effective October 15, 2015

Time Study and MAC Guide (.pdf)

Notices

View a list of important notices regarding Medicaid Administrative Claiming for Local Health Districts.

Participation Documents

Contracting Information

The purpose of the Medicaid Administrative Claiming (MAC) program is to provide State affiliated public agencies in Texas the opportunity to submit reimbursement claims for administrative activities that support the Medicaid program. In order to participate in the MAC program, the LHD provider must be a public entity and enter into a MAC contract with the Texas Health & Human Services Commission (HHSC).

In addition to the contracting process, each LHD provider must also have an active Texas Provider Identifier (TPI) and/or National Provider Identifier (NPI), meet HHSC training requirements and participate in the Random Moment Time Study (RMTS), which includes the certification of the participant list and participation in the time study. To enroll as a Medicaid provider, please complete the Texas Medicaid fee-for-service provider enrollment form on the Texas Medicaid and Healthcare Partnership (TMHP) website:

Visit the TMHP provider enrollment site.

An LHD provider that is interested in participating for this upcoming Federal Fiscal Year (FFY) should consider beginning the process as soon as possible, as it may take many months to complete all paperwork and training requirements.

Listing and links to all forms required for participation in the MAC program by LHD's.

Training

The link below contains information regarding the LHD training information. It is IMPORTANT to carefully read all the information provided so as to fully understand who must attend "initial" training and who is eligible to take "refresher" training.

Learn more about training opportunities