What is a fiscal intermediary?

What are the two employer options?

How do I choose Option One or Option Two?

What employer costs am I responsible for?

What are the fiscal intermediary’s responsibilities?

What are my responsibilities?

What are the personal care agency’s responsibilities?

Who hires the PCA?

How does a PCA sign up for direct deposit?

What are your business hours?

When are timesheets due in the FI (Fiscal Intermediary) office?

Should I fax or mail my timesheets in?

When are your fax machines on?

When can I call to find out whether you received my timesheet(s) or not?

When should I expect to receive my payroll checks?

My check was mailed out, but I haven't received it…what should I do now?

What do I do if I receive the check I placed a stop payment on previously?

Did my pay go direct deposit? (First payment by Direct Deposit)

Why didn't I get paid for all the hours submitted on my timesheet?

Why doesn't a PCA get paid when a consumer is in the hospital or long term care facility?

Will Mass Health pay my PCAs for overtime?

Do PCAs get overtime pay for holidays?

How is the pay calculated for holiday hour’s work?

How much does my PCA get paid for working overnight?

Will MassHealth pay my PCAs for jury duty?

What if one of my PCAs gets injured on the job?

How many hours do I have left on my approval for regular hours and for holidays?

Why did I get a letter from the Fiscal Intermediary saying I was overusing my hours?

Can you explain the overuse letter to me?

How can I get more timesheets, W-4s, I-9s, PCA Signature forms, or the payroll calendar?

What is my four digit consumer number?

Can I have copies of my payroll registers?

Will Northeast Arc FI do my PCA wage verifications?

Who chooses my fiscal intermediary?

What if I have problems with the fiscal intermediary?

What is the Office of Inspector General (OIG) Verification?

What is the 1199 SEIU Union?

What if I need more information?

 

What is a fiscal intermediary?
A fiscal intermediary is a company contracted by MassHealth, Senior Care Options Programs and Aging Services Access Points (ASAPs) that can help you with the financial responsibilities of employing PCAs and handling all the payroll responsibilities, such as:
Paying your share of state and federal taxes
Buying workers’ compensation insurance for your PCAs
Paying your share of unemployment taxes
Preparing your PCAs’ payroll checks and direct deposits

You must decide whether you want the fiscal intermediary to help you with these responsibilities by choosing one of the two employer options.

What are the two employer options?
Option One: Consumer Delegated
You should choose Option One if you want the fiscal intermediary to:
send you the forms you need
withhold and pay your PCAs’ state and federal income taxes
pay your share of state and federal unemployment taxes
buy workers’ compensation insurance for your PCAs
prepare your PCAs’ payroll checks and direct deposits
prepare and file your employer tax reports with appropriate government agencies
The benefit of Option One is that you do not have to worry whether you are withholding and filing taxes correctly. The fiscal intermediary will send you already prepared paychecks every other week for you to give to your PCAs. Also, if you have a surrogate you must choose Option One.
Option Two: Consumer Directed
You should choose Option Two if you want to:
obtain the forms you need
withhold and pay your PCAs’ state and federal income taxes
pay your share of state and federal unemployment taxes
buy workers’ compensation insurance for your PCAs
prepare your PCAs’ payroll checks
prepare and file your employer tax reports with appropriate government agencies
The benefit of Option Two is that you can perform independently all these tasks that are required of you as the employer of your PCA. Under this option the fiscal intermediary will send you one check that will include payment for your PCAs’ wages, taxes and workers’ compensation premiums. You will use these funds to prepare checks for your PCAs and to pay your taxes and insurance premiums.

How do I choose Option One or Option Two?
The fiscal intermediary or your Skills Trainer will contact you to fill out a Consumer Agreement in which you choose either Option One or Option Two. If you are not sure which employer option is best for you, your personal care agency can help you make a decision.

What employer costs am I responsible for?
As the employer of your PCAs you are responsible for paying your share of:
State and federal unemployment taxes
workers’ compensation insurance premium
employer’s share of PCA’s social security and Medicare taxes
These costs are paid by your fiscal intermediary if you select Option One when signing the Consumer Agreement. If you select Option Two, the cost of these items is included in the gross payment made to you for processing your payroll.

What are the fiscal intermediary’s responsibilities?
For both Option One and Option Two the fiscal intermediary is responsible for:
contacting you to sign the consumer agreement so you can choose one of the two employer options
making sure you are approved by MassHealth to receive PCA services
giving you Activity Forms (time sheets) to record the actual time your PCAs
helped you with ADLs and IADLs
notifying your personal care agency of Mass Health’s decision about your PCA services
making sure the Activity Forms are accurate and contacting you if there is a mistake
keeping financial records
sending PCA claims to MassHealth
explaining its complaint policy to you

What are my responsibilities?
No matter which employer option you choose, you are responsible for:
signing the consumer agreement choosing Option One or Option Two
hiring, firing, training and scheduling your PCAs
completing and turning in activity forms to the fiscal intermediary
following the rules of the PCA program
paying your PCAs correctly and on time
letting the personal care agency know if you unexpectedly need overtime pay for one of your PCAs
notifying the fiscal intermediary of any changes with your PCAs with your personal care agency, making a list of PCAs to contact if your regular PCAs are unavailable

If you choose Option One you are also responsible for:
completing all forms sent to you and returning them to the fiscal intermediary
working with your fiscal intermediary to settle any PCA payment problems or complaints
informing the fiscal intermediary whether your PCAs prefer to receive paychecks or direct deposit

If you choose Option Two you are also responsible for:
completing all forms sent to you and returning them to the fiscal intermediary
preparing your PCAs’ checks and providing the fiscal intermediary with proof you are meeting your employer responsibilities
paying taxes for both you and your PCAs and buying workers’ compensation insurance for your PCAs
complying with all laws that apply to you as an employer of PCAs
paying your PCAs according to the rates set by the Division of Health Care Finance and Policy (DHCFP)
preparing your PCAs’ checks

What are the personal care agency’s responsibilities?
Your personal care agency is responsible for:
assessing your eligibility for the PCA program
asking MassHealth for approval for PCA services
assessing whether you need a surrogate
teaching you to manage your PCAs
evaluating the kind and amount of services you need
teaching you how to complete your PCAs’ Activity Forms
working out a personal care services plan with you that lists all the services you need to live in your home
helping you decide which employer option is better for you

Who hires the PCA?
If MassHealth approves PCA services for you, you will recruit, hire, fire, train and schedule your own PCAs. Remember, you are the employer in this program. Northeast Arc FI is your fiscal employer agent for processing payrolls and paying and filing taxes with government agencies- but you are the employer. The personal care agency can help you by:
offering skills training to help you learn how to do these tasks
assessing whether you need a surrogate to help you with some or all of these tasks
teaching you how to complete PCA timesheets (also known as Activity Forms).

How does a PCA sign up for direct deposit?
Please request a Direct Deposit Application from our Customer Service Department or print the form from our list of forms on this site. Complete and fax the form to us and we will process it to make sure your next payroll is directly deposited.

What are your business hours?
Our Customer Service Department is available to answer your calls 9:00 A.M. to 5:00 P.M. Monday thru Friday.

When are timesheets due in the FI (Fiscal Intermediary) office?
We need to have your PCA’s timesheets in the FI office no later than 4.00p.m on the Monday after the payroll period ends (including when the Monday is a holiday).  This will ensure your PCA getting paid on Friday.

Should I fax or mail my timesheets in?
For faster payment of timesheets we strongly recommend that you fax them to us. Our fax number is 978-777-3635.

When are your fax machines on?
Our fax machines are available to receive faxes 24 hours a day and seven day per week so consumers may send timesheets whenever it is convenient for them.

When can I call to find out whether you received my timesheet(s) or not?
If you faxed the time sheet between Friday afternoon and Sunday night you should call after 3.00 PM on Monday.  If you faxed it between Monday morning and 4.00 P.M. you should call after 3.00 P.M. on Tuesday. If you faxed it after 4.00 P.M. on Monday your time sheet will be considered late.  If this time sheet has errors it will delay your PCA payment and may be paid in the next week.

When should I expect to receive my payroll checks?
If we get your timesheets by 4.00.pm. on Monday and it is properly filled out, you can expect to receive your check(s) or direct deposit by Friday.

My check was mailed out, but I haven't received it…what should I do now?
Please give us a call on Monday. If we are able to verify that you have been paid - and that shouldn't be a problem if we've gotten your timesheets on time - you may request that we put a stop payment on the check(s). We will issue new checks after five business days - sorry, but we can't make exceptions.

What do I do if I receive the check I placed a stop payment on previously?
Your PCAs won't be able to cash these checks, so please write VOID across the check and mail it back to our office as soon as you can.

Did my pay go direct deposit? (First payment by Direct Deposit)
To verify if your PCA payment was deposited into your bank account on the Friday of your pay cycle, please call your bank first. At the same time, your employer will be getting the non-negotiable check voucher with your payroll information on it.

Why didn't I get paid for all the hours submitted on my timesheet?
There could be different reasons for this. So we recommend that you call our Customer Service Department.

Why doesn't a PCA get paid when a consumer is in the hospital or long term care facility?
The MassHealth PCA Program does not authorize PCA Services when the consumer is in the hospital or in a long term facility. There are no exceptions.

Will Mass Health pay my PCAs for overtime?
If MassHealth has approved more than 40 hours per week of PCA services for you, MassHealth expects you to hire at least two PCAs so that none of your PCAs have to work for you more than 40 hours in one week. MassHealth expects you to schedule each PCA for no more than 40 hours each week. MassHealth also expects you to have a back-up list of PCAs in case your scheduled PCA cannot work that day. MassHealth will not pay over-time unless there is an unexpected event that prevents your regularly scheduled PCA from providing PCA services and the only PCA you can find to cover will need to work for you more than 40 hours that week.

Do PCAs get overtime pay for holidays?
Yes, but there only for four holidays approved for overtime in this program. They are New Years Day, 4th of July, Thanksgiving Day and Christmas Day.

How is the pay calculated for holiday hour’s work?
For holiday hours, you get an hour at the regular rate plus an additional half- hour of pay, bringing the payment for holiday hours to one-and-a-half times the regular rate. If you use more than the holiday hours assigned to you on your approval, then you will only receive the regular rate.

How much does my PCA get paid for working overnight?
When your PCAs work as night attendants between 12:00 A.M. and 6:00 A.M., they get paid for 2 hours at $12.48/hr.  There is no overtime pay for night hours worked on any of the four holidays.

Will MassHealth pay my PCAs for jury duty?
MassHealth will pay for jury duty. Please contact your personal care agency for assistance requesting hours for jury duty.

What if one of my PCAs gets injured on the job?
If you selected Option One, call your fiscal intermediary immediately. If you selected Option Two, follow your workers’ compensation insurance company’s instructions. For both options you can get information about workers’ compensation insurance and coverage by calling the Department of Industrial Accidents at the telephone number listed on the PCA Contact Page.

How many hours do I have left on my approval for regular hours and for holidays?
If you would like to learn the unused balance of your regular or holiday hours, please contact our Customer Service Department.

Why did I get a letter from the Fiscal Intermediary saying I was overusing my hours?
We send you letters notifying of overuse in order to make sure you do not run out of hours toward the end of your approval. If you have any questions about our findings, please contact our Customer Service Department.

Can you explain the overuse letter to me?
We calculate the overuse hours on the last two timesheets you submit covering four weeks. During this period, if your use exceeds four times your weekly allowable hours indicated on your approval, then we send an overuse letter. If we see the overuse continue over three pay periods, then we request skills training for you from your PCM agency. If we see continued overuse, then we must report it to MassHealth. MassHealth may then "cap" your hours, meaning that we can't pay you for more than your weekly approved hours.

How can I get more timesheets, W-4s, I-9s, PCA Signature forms, or the payroll calendar?
You can download them from our site and print them from home if you have access to a printer. If you do not have access to a printer, you can request to have forms mailed to you by calling our Customer Service Department.

What is my four digit consumer number?
We assign you a four digit number when you enroll in the FI program. This number along with your name will identify you as a consumer with us.  We will send you a welcome packet containing a letter informing you of this new employer number along with your weekly schedule and some blank timesheets. We require you to use your employer number on the timesheets and all documents you submit to our office. This number also appears at the bottom of the payroll register that accompany the payroll checks you receive each pay period.

Can I have copies of my payroll registers?
You can request copies of payroll registers by calling our Customer Service Department.

Will Northeast Arc FI do my PCA wage verifications?
Northeast Arc FI will provide wage verifications only for DUA (Division of Unemployment Assistance), Social Security Administration, Division of Transitional Assistance (DTA), and the courts (if subpoenaed).

Who chooses my fiscal intermediary?
The personal care agency that provides your personal care services will choose a fiscal intermediary for you and all the other consumers it serves.

What if I have problems with the fiscal intermediary?
The fiscal intermediary has a plan for dealing with any complaints. The fiscal intermediary will explain the plan to you and make every effort to work with you to resolve your complaint or problem. If you follow the complaint plan and you are still not satisfied, call your personal care agency and ask them to help you resolve the problem with the fiscal intermediary.

What is the Office of Inspector General (OIG) Verification?
We are required by law to check your new PCA hires on the OIG website to see if there are any restrictions for their employment. If their name appears on this list, we will notify you immediately and no payroll can be processed for these individuals.

What is the 1199 SEIU Union?
All the PCAs in the state now have a union that they can join. Please remind all your PCAs of this. You can download an application from this website; request them from the union or from our Customer Service Department.

What if I need more information?
Call your fiscal intermediary if you:
have questions about your Activity Forms that can be answered over the telephone
have questions about the employment forms sent to you by the fiscal intermediary that can be answered over the telephone
need Activity Forms
have questions about paying your PCAs
Call your Personal Care Agency if you:
have questions about hiring, firing, training scheduling your PCAs
have questions about the process of requesting overtime pay, or need to request overtime pay for one of your PCAs
need more skills training to assist you in managing your PCA services
have questions your fiscal intermediary cannot answer by telephone and you need a face-to-face meeting with a skills instructor