providing information as requested to EOHHS or its designee related to potential RMTS participants; ensuring that RMTS participants who are engaged in Direct Services Claiming activities on behalf of the Provider have completed the online RMTS training; and ensuring an RMTS response rate of participants who are engaged in Direct Service Claiming activities on behalf of the Provider at a minimum of 85%. EOHHS will provide Interim Rate payments for Direct Services on a quarterly basis. Interim Rate payments are based on per-unit-service claims filed by the Provider in accordance with sub-regulatory guidance and the following requirements. The Provider shall only submit claims for Interim Rates for Direct Services provided in accordance with Section 2.2.A of this Contract. After the close of each State Fiscal Year, any Interim Rates paid to the Provider will be reconciled to actual costs as determined by EOHHS based on the submitted Massachusetts School-Based Direct Services Cost Provider’s Report. Interim Rates will be reconciled according to the following process. Certified costs on the Massachusetts School-Based Direct Services Cost Report will be compared to the Interim Rate claims for services Provider’s delivered during the reporting period, as documented in the Commonwealth’s Medicaid Management Information System (MMIS). The Interim Rate claims will be adjusted to reflect, in the Provider’s aggregate, the total Medicaid-allowable actual incurred costs based on the certified Massachusetts School-Based Direct Services Cost Report. If EOHHS determines that an underpayment has been made, the difference between the value of the Interim Rate and the value of the certified costs on the Massachusetts School-Based Direct Services Cost Report will be paid to the Provider. If EOHHS determines that an overpayment has been made, EOHHS will recoup the amount of the overpayment from the Provider. Administrative Activities Claiming Final payment for Administrative Activities is based on Medicaid-allowable actual incurred costs related to Administrative Activities. To receive payment for Administrative Activities, the Provider must submit actual costs using the Massachusetts School-Based Administrative Activities Cost Report on an annual basis and in accordance with timelines issued by MassHealth; submit actual costs using the Massachusetts School-Based Administrative Activities Cost Report in accordance with the Instruction Guide for the Massachusetts School- Based Administrative Activities Cost Report, issued by MassHealth; and participate in the Massachusetts statewide RMTS, including:
providing information as requested to EOHHS or its designee related to potential RMTS participants; ensuring that RMTS participants who are engaged in Direct Services Claiming activities on behalf of the Provider have completed the online RMTS training; and ensuring an RMTS response rate of participants who are engaged in Direct Service Claiming activities on behalf of the Provider at a minimum of 85%. EOHHS will provide Interim Rate payments for Direct Services on a quarterly basis. Interim Rate payments are based on per-unit-service claims filed by the Provider in accordance with sub-regulatory guidance and the following requirements. The Provider shall only submit claims for Interim Rates for Direct Services provided in accordance with Section 2.2.A of this Contract. After the close of each State Fiscal Year, any Interim Rates paid to the Provider will be reconciled to actual costs as determined by EOHHS based on the Provider’s submitted Massachusetts School-Based Direct Services Cost Report. Interim Rates will be reconciled according to the following process. Certified costs on the Massachusetts School-Based Direct Services Cost Report will be compared to the Provider’s Interim Rate claims for services delivered during the reporting period, as documented in the Commonwealth’s Medicaid Management Information System (MMIS). The Provider’s Interim Rate claims will be adjusted to reflect, in the aggregate, the total Medicaid-allowable actual incurred costs based on the certified Massachusetts School-Based Direct Services Cost Report. If EOHHS determines that an underpayment has been made, the difference between the value of the Interim Rate and the value of the certified costs on the Massachusetts School-Based Direct Services Cost Report will be paid to the Provider. If EOHHS determines that an overpayment has been made, EOHHS will recoup the amount of the overpayment from the Provider. Administrative Activities Claiming Final payment for Administrative Activities is based on Medicaid-allowable actual incurred costs related to Administrative Activities. To receive payment for Administrative Activities, the Provider must submit actual costs using the Massachusetts School-Based Administrative Activities Cost Report on an annual basis and in accordance with timelines issued by MassHealth; submit actual costs using the Massachusetts School-Based Administrative Activities Cost Report in accordance with the Instruction Guide for the Massachusetts School- Based Administrative Activities Cost Report, issued by MassHealth; and participate in the Massachusetts statewide RMTS, including: