Section 16.03.13.310 - FISCAL EMPLOYER AGENT DUTIES AND RESPONSIBILITIES: PERFORMANCE METRICSThe provider must do the following:
01.Readiness Review. Complete a readiness review conducted by the Department with the provider prior to providing fiscal employer agent services.a. The provider must complete one hundred percent (100%) of the readiness review.b. The Department will access SFTP site for review of provider documents and conduct an onsite review.02.Compliance with Tax Regulations and Labor Laws. Ensure each participant's compliance with regulations for both federal and state taxes, and all applicable labor laws.03.Fiscal Support and Financial Consultation. a. The provider must provide each participant with fiscal support and financial consultation.b. The provider must respond to ninety-five percent (95%) of calls and voicemails within two (2) business days and to written and electronic correspondence within five business (5) days.04.Federal and State Forms Submitted. Ensure each participant's compliance with regulations for both federal and state taxes, including preparation and submission of all federal and state forms for each participant and their employees.05.Mandatory Reporting, Withholding, and Payment. Perform all mandatory reporting, withholding, and payment actions according to the compliance requirements of the state and federal agencies.06.Payroll Checks. Issue payroll checks within the two (2) week or semi-monthly payroll cycle, after receipt of completed, approved time sheets.07.Adherence to Support and Spending Plan. Distribute payments to each participant employee under the participant's support and spending plan.08.Record Activities. Record all activities in an individual file for each participant and their employees.09.Records in Participant File. Maintain complete records in each participant's file.10.Manage Phone, Fax, and E-Mail for Fiscal and Financial Questions. a. The provider must manage toll-free telephone line, fax, and e-mail related to participant fiscal and financial questions.b. The provider must respond to ninety-five percent (95%) of calls and voicemails within two (2) business days and to written and electronic correspondence within five (5) business days.11.Track Complaints and Complaint Resolution. a. The provider must maintain a register of complaints from participants, participant employees, and others, with corrective action implemented by the provider within one (1) business day of the complaint response.b. The provider must respond to ninety-five percent (95%) of calls and voicemails within two (2) business days and to written and electronic complaints within five (5) business days.12.Web Access to Electronic Time Sheet Entry. Maintain web access to electronic time sheet entry for participants.13.Participant Enrollment Packets and Employment Packets. Prepare and distribute participant enrollment and employment packets to each participant.14.Payroll Spending Summaries. Provide each participant with payroll spending summaries and information about how to read the payroll spending summary each time payroll is executed.15.Quarterly Reconciliation. Each fiscal quarter after initiating service, the provider must reconcile its Medicaid Billing Report to a zero-dollar ($0) balance with the Medicaid Bureau of Financial Operations. The provider has ninety (90) days to comply with reconciling each participant's spending plan balance to a zero dollar ($0) balance with Medicaid's reimbursements. The provider must:a. Have one hundred percent (100%) compliance with the required quarterly reconciliation of the Medicaid Billing Report.b. Notify the Department immediately if an issue is identified that may result in the provider not reconciling the Medicaid Billing Report. The Department will notify the provider when a performance issue is identified. The Department may require the provider to submit a written corrective action plan for Department approval within two (2) business days after notification. If the provider fails to reconcile within ninety (90) days after the end of each quarter, the provider will be penalized fifty dollars ($50) each week until the provider has reconciled with Medicaid to a zero dollar ($0) balance.16.Cash Management Plan. Each provider's cash management plan must equal one point five (1.5) times the monthly payroll cycle amount and can be forms of liquid cash and lines of credit. For example, if a provider's current payroll minimum has averaged one hundred thousand dollars ($100,000) per payroll cycle, the provider would be required to have one hundred fifty thousand dollars ($150,000) in a cash management plan. The Department must be on the notification list if any lines of credit are decreased in the amount accessible or terminated. The expectation is to provide a seamless payroll cycle to the participant, without loss of pay to their employees.Idaho Admin. Code r. 16.03.13.310