CBTs and Joint Training

Financial Management Services Agencies (FMSA) Enrollment Training

Financial Management Services Agencies (FMSAs) provide Financial Management Services (FMS) to individuals who hire their own service providers under the Consumer Directed Services (CDS) option for certain long-term services and supports. Businesses or other entities that want to be an FMSA must complete a 3-day training course provided by Health and Human Services (HHS).

FMSAs serve as the vendor fiscal/employer agents for individuals who hire their own employees for their Medicaid services. FMSAs provide payroll services and deposit and report withholding taxes on behalf of individuals who employ their service providers. FMSAs assume tax liability for proper withholding of federal income taxes and federal unemployment tax in accordance with Section 3504 of the Internal Revenue Code. In addition, an FMSA must comply with state laws and regulations of the Texas Workforce Commission regarding payment of state unemployment insurance.

FMSAs do NOT deliver direct in-home or community- based services, such as attendant services.

What does an FMSA do?

FMSAs have the following roles and responsibilities:

  • providing a required face to face initial orientation to individuals when they first choose the CDS option;
  • providing ongoing training, assistance, and support for employer-related responsibilities;
  • verifying qualifications of applicants before services are delivered;
  • monitoring continued eligibility of service providers;
  • approving and monitoring budgets for services delivered through the CDS option;
  • ensuring that all service agreements are fully executed for each of the employer's service providers before issuing the initial payment for services to the service provider;
  • managing payroll, including calculations of employee withholdings and employer contributions and depositing these funds with appropriate agencies (FMSAs are not allowed to use a payroll agent);
  • complying with applicable government regulations concerning employee withholdings, garnishments, mandated withholdings, and benefits;
  • preparing and filing required tax forms and reports;
  • paying allowable expenses incurred by the employer;
  • providing status reports concerning the individual's budget, expenditures, and compliance with CDS option requirements; and
  • responding to the employer or the employer's designated representative as soon as possible but at least within two working days after receipt of information requiring a response from the FMSA, unless indicated otherwise in this chapter.

The FMSA must accept the designated fee established by the Health and Human Services Commission as payment in full for FMS delivered. The rate for FMS ranges from $202 per month for some waiver programs to $110 per month for Primary Home Care, Family Care, Community Attendant Services, and Personal Care Services delivered by the Department of State Health Services. To learn more about rate for CDS services see the Health and Human Services Commission, Rate Analysis Department rates at http://rad.hhs.texas.gov/long-term-services-supports

Additional FMSA Contracting Requirements

An applicant must also be able and willing to fulfill the requirements, TAC 40, Part 1, Chapter 49, for contracting with community care services: https://hhs.texas.gov/doing-business-hhs/provider-portals/long-term-care-providers/consumer-directed-services-cds/how-become-a-cds-provider

FMSAs must pay for services first and then bill the state for reimbursement. Entities should have at least two months operating funds when they apply for a contract to become an FMSA.

HHS conducts contract monitoring of FMSAs. The contract monitoring tools may be viewed at: https://hhs.texas.gov/doing-business-hhs/provider-portals/long-term-care-providers/contract-and-fiscal-compliance-monitoring-tools

Important: Certification of an entity as an FMSA does not guarantee any referrals. All FMSAs are included on a choice list provided to individuals who have chosen the CDS option.

Why is training certification necessary for FMSAs?

FMS is a highly complex and technical service. It requires thorough understanding of and rigid compliance with federal laws and rules of the Internal Revenue Service relating to being a fiscal employer agent on behalf of individuals using Medicaid funded programs. FMSAs must have a working knowledge of all home- and community-based services provided by HHS, as well as knowledge of principles of self-determination and person first language and practices.

Training Attendance Requirements

To be considered eligible for an FMSA contract:

  • At least 2 key operations staff, including the program manager and payroll staff must attend each presentation, each day of the training to apply to contract with HHS as an FMSA.
  • All trainees must sign in each day in order to be considered eligible for a contract.
  • All trainees must demonstrate understanding of the material by passing a knowledge test at the end of the 3-day training.

Important note: Attendance does not obligate an applicant to contract with HHS.

Training Prerequisites

Prior to attending the HHS FMSA training, participants must read the Consumer Directed Services Option Rules (PDF), located in the Texas Administrative Code, Title 40, Chapter 41, Consumer Directed Services (CDS) Option. Print and bring a copy of these rules to the training.

Basic Course Description

  • Training objectives
  • The CDS Option — Consumer/Employer Perspective
  • Overview of the CDS Option
  • Responsibilities of FMSAs (Texas Administrative Code, Title 40, Part 1, Chapter 41)
  • Vendor Fiscal/Agent Responsibilities — Internal Revenue Service (IRS) Registration and Reporting Requirements
  • Subchapter C: Enrollment and Responsibilities of Financial Management Services Agencies
  • Subchapter F: Support Consultation Services and Support Advisor Responsibilities
  • Subchapter D: Enrollment, Transfer, Suspension and Termination
  • Subchapter E: Budgets (CDS Budget Workbook and Quarterly Report)
    • CDS Forms
    • Billing
  • Billing Units
  • Bill Code Crosswalk
  • Texas Medicaid Healthcare Partnership (TMHP)
  • Client Assessment and Registration (CARE) — HCS and TxHmL
  • Texas Workforce Commission Requirements and Resources (State Unemployment Tax Reporting)
  • Overview of HHS Programs with the CDS Option — Program Specific Rules
  • CDS Fraud Reporting Process
  • Contracting Requirements for New FMSAs (Texas Administrative Code, Title 40, Part 1, Chapter 49)
  • FMSA Monitoring
  • Knowledge Test

The agenda for the three-day training may vary depending on the schedule of presenters.

Business entities are asked to limit the registration and attendance of their employees to no more than three persons. Each staff person must be registered under the same entity name to receive credit for attendance.

Special Accommodations

Please contact cds@hhsc.state.tx.us regarding accommodations for the classroom training or for taking the written test.

Location

Brown-Heatly Buidling
Public Hearing Room
4900 N. Lamar Blvd.
Austin, TX 78751

Register for Training

Federal Government

  • Internal Revenue Service training is provided as part of the HHS required training.

Provided by Other Entities

  • Texas Workforce Commission training is provided as part of the HHS required training.