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Medicaid Administrative Claiming MAC

Medicaid Administrative Claiming (MAC) is a Texas Medicaid program (operated statewide by Health & Human Services Commission-HHSC and Fairbanks, LLC) that reimburses school districts and other agencies for certain outreach and case management activities provided. These activities may be to a student or their family and include coordinating, referring, or assisting student/family in accessing needed medical/health or mental health services. Reimbursement is determined through a statewide time study in which the district must participate. The time study methodology used is a Random Moment Time Study (RMTS.) The purpose of the time study is to:

  • Identify the proportion of administrative time allowable and reimbursable under the MAC program.
  • Identify the proportion of direct service time allowable and reimbursable under the SHARS Medicaid program for cost reporting and rate setting.

RMTS Processes and Compliance

  • Selected District staff must participate in the RMTS for the District to submit claims for either MAC or SHARS.
  • Random time study "moments" are sampled throughout a quarter (October - December, January - March or April - June.) A participant may have more than one moment during the quarter.
  • A moment represents one minute at a particular time.

If you are sampled for a moment, your only responsibility is to document what you were doing at that precise moment (one minute) by answering four questions online.