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Random Moment Time Study

The Random Moment Time Study or RMTS, helps DODD, county boards of developmental disabilities, and councils of governments document the time employees spend on administrative duties that support Medicaid-funded services. The RMTS methodology is used to satisfy the CMS requirements for collecting funds through the Medicaid Administrative Claiming or MAC program.

RMTS training is available online in DODD's MyLearning. 

 

Click through the tabs below for more information.

Overview for Coordinators

How will RMTS coordinators know if or when staff have RMTS moments to answer?

MAC Coordinators and Assistant MAC Coordinators will be copied on the 24-hour in advance notifications sent to staff. This will alert the coordinators that a specific participant in their county board of developmental disabilities or council of government has been randomly selected for a moment.

It is important that participants respond to their sampled moments to ensure we meet our compliance rate. Failure to meet the compliance rate will negatively impact reimbursements. Thus, both MAC Coordinators and Assistant MAC Coordinators will be copied on all reminder emails if the participant has not responded to their sampled moment. It is the responsibility of the local MAC Coordinators and Assistant MAC Coordinators to ensure participants respond timely and accurately to their sampled moments.

 

What if superintendents or staff are shared with another county board of developmental disabilities?

Some county boards of developmental disabilities share superintendents and other staff. If the shared superintendent or staff is performing MAC eligible activities for more than one county, then each county may include this person on their quarterly participant lists. The shared participant will receive a unique user ID for each county board that includes them on its participant list.

If sampled, the participant must use the appropriate user ID and respond to the moment. If the participant is working on behalf of the other county board when sampled, then they should select the pre-written online response “not working” followed by “not scheduled to work.” If the shared superintendent or staff only participates in RMTS for one county board, then the participant answers the moment based on the activity being performed at the time of the moment, regardless of which county they are working for at the time.

 

How are staff trained?

Before answering their first moment, participants must complete the RMTS web-based training available in DODD MyLearning. In the event that a participant needs to review the training again, they may access the online training or the PowerPoint version of the training on the department’s website. Reviewing only the PowerPoint does not qualify as completing the training.

Once they have completed the initial training, participants do not need to take the training again. The county boards of developmental disabilities and council of governments may implement additional training for their participants. DODD may require additional training later as well.

What happens when a validation moment is received?

As part of our commitment to collecting complete and accurate information through the RMTS program, MAC Coordinators and Assistant MAC Coordinators will be responsible for validating 5% of all moments.

The State MAC Program Administrator will generate the validation sample and email the listing to the MAC Coordinators and Assistant MAC Coordinators. It is the responsibility of the coordinators and assistant coordinators to ensure

  • that the participants respond to their sampled moments timely and accurately,
  • and that the uploaded support documentation contains the participant’s name, date of moment, time of moment, and accurately reflects the activity performed at the date and time of the moment.

The coordinators and assistant coordinators may encourage the participants who have validation moments to answer their moments in a timelier manner since the coordinators or assistant coordinators are required to review the online answers and support documentation, complete any follow-up if needed, and also notify DODD of the moment’s successful and accurate completion before the end of the five business day grace period.

If a correction is needed to the RMTS responses or the support documentation, the coordinators or assistant coordinators are to provide guidance to the participant and request that the participant edit the appropriate item. The correction must be made within the moment’s five business day grace period. If the participant is not available to make the edits, please send the information to mac-coordinator@list.dodd.ohio.gov so the State MAC Program Administrator or designee can make the needed updates for the participant. This must be completed within the moment’s five business day grace period. No changes nor edits can be made after the five business day grace period expires.

Once the coordinator or assistant coordinator has reviewed the validation moment, and any corrections or updates have been made, then the coordinator or assistant coordinator must email mac-coordinator@list. dodd.ohio.gov informing the State MAC Program Administrator that the county board of developmental disabilities or council of governments has reviewed the validation moment and that the moment is ready for DODD’s final review. This must be done within the moment’s five business day grace period. If DODD has any feedback, they will contact the coordinator or assistant coordinator.

It is important to note that you may not, under any circumstances, notify participants that they have been selected for a random moment prior to the receipt of the 24-hour notification email sent to them prior to their sampled moment.

Overview for Particpants

What is the Random Moment in Time Survey?

Also called RMTS for short, it is the methodology for determining the percent of time staff spend working on Medicaid-related administrative activities. This data is used to seek Federal Medicaid reimbursement through the Medicaid Administrative Claiming, or MAC, program. The RMTS methodology involves randomly sampling participants throughout a quarter and requiring them to document what they are doing at specific random moments in time.

The results of the RMTS sampling are used in calculating the reimbursement generated. Random moments are selected Monday through Friday, excluding holidays, between the core hours of 9 AM and 3 PM.

How many people or entities are participating in RMTS?

As of October 2018, a combined total of around 1,020 participants from 82 county boards of developmental disabilities and seven council of governments participated, as well as about 314 staff from the Ohio Department of Developmental Disabilities, or DODD, central office.

Who is participating in RMTS?

Staff whose work involves support of Medicaid programs are included in the time study of each quarter, as determined by the local MAC Coordinator in conjunction with DODD’s State MAC Program Administrator.

How will participants know if they are selected to respond to a moment?

Participants will receive an email one day prior to a moment. This will be their advance notification that they have been selected for a moment. The email will contain the exact date and time of the moment. Participants will also receive a reminder around the time when the moment actually happens. Participants will have 5 business days to respond to the moment before it expires. If the participant does not respond promptly, reminder emails will be sent 48 hours and 72 hours after the moment occurred.

When responding to a selected moment, participants will answer three questions. Each question will have a list of predefined answers. You should simply select from the pre-written/available options. You will also type in a more detailed description of your activity in a yellow text box and upload appropriate support documentation. The three questions will always be

  • What type of activity were you doing?
  • What were you specifically doing in this category?
  • Who were you working with?

What about training?

Prior to answering their first moment, participants must complete the RMTS web-based training, available in DODD MyLearning. Participants can review concepts from the training using the RMTS manual. Reviewing only the RMTS manual does not meet the RMTS training requirement.

Once they have completed the initial training, participants do not need to take the training again. Additional training may be required at a later date.

What if a participant is not available to answer the selected moment?

If the participant is away from their workstation, they can reply when they return. Participants have a grace period of five business days.

If a county board of developmental disabilities or council of government participant is on leave or otherwise unable to answer the moment within the five business day grace period, the MAC Coordinator or Assistant Coordinator should send supporting documentation to mac-coordinator@list.dodd.ohio.gov for review by DODD’s State MAC Program Administrator. If everything is in order, the MAC Administrator can answer the moment on behalf of the participant, as long as the moment’s five business day grace period has not expired.

If a Central Office participant is on leave at the time of the moment and will not return in time to answer the moment, the MAC Administrator will contact the supervisor for information and, when appropriate, may answer the moment on behalf of the participant as long as the five business day grace period has not expired.

What happens if a participant doesn’t respond to a moment within the five day grace period?

If a moment expired without a response, it is counted as a missed moment or non-response. If we fail to meet a statewide compliance rate of 85%, then non-responses will be added to the MAC reimbursement calculation, which will result in reduced revenue. Therefore, it is very important that participants who are selected for moments to make every effort to respond regardless of what their schedule or activity is at the time.

 

Corrective Action Plan

For county boards of developmental disabilities and councils of government with continuing performance issues regarding the Random Moment in the following corrective action steps may be implemented.

1. Requiring corrective action plans from county boards of developmental disabilities and councils of governments, as determined by DODD.

Plans may include

  • retraining participants on the specific performance issue identified,
  • attending a training for coordinators regarding the specific performance issue identified, led by staff of DODD,
  • submitting a written explanation from the coordinator, signed by the superintendent, regarding why the coordinator allowed the insufficient documentation to remain uncorrected,
  • submitting a written plan of how the county board of developmental disabilities or council of governments’ support documentation review system will be improved or changed to meet the RMTS requirements,
  • requiring coordinators to validate additional RMTS moments and forward them to DODD for verification,
  • an in-person meeting between the county board of developmental disabilities or council of government coordiator, assistant coordinator, and the DODD State Coordinator and administrator,
  • or replacing the coordinator or assistant coordinator.

2. Placing the entity on payment hold until the corrective action plan is reviewed and approved by DODD.

3. Excluding entity for the RMTS program for one or more quarters if performance issue persist despite the corrective action plan.

Triggers for implementing a corrective action plan include

  • failure to cooperate with state or federal staff during reviews or other requests for information,
  • failure to submit quarterly or annual implementation plans,
  • failure to provide accurate and timely information to the State MAC Program Administrator as required,
  • failure by MAC Coordinator and Assistant MAC Coordinator to attend mandatory training sessions as scheduled by the State MAC Program Administrator,
  • significant issues found during previous RMTS reviews,
  • entities with consecutive years of findings,
  • entities whose claims have needed reconciled during the past year,
  • entities who forgot or are late with validations, or
  • entities with greater than 15% and greater than five missed moments for a quarter.
Severity Remedial Action and Sanctions
   Minimal

 Additional training or formal written response by county addressing DODD’s concerns and request for information

   Moderate

 Formal corrective action plan required to address areas of deficiency in programs as identified by DODD

   Significant

 Claiming entity placed on payment hold

   Severe

 Recovery of funds or exclusion of participation