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Claim Calculations and Recalculations in the CACFP 810 First Street, N.E., Washington, DC 20002 –...

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Claim Calculations and Recalculations in the CACFP 810 First Street, N.E., Washington, DC 20002 – 3 rd Floor Grand Hall, Side A
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Page 1: Claim Calculations and Recalculations in the CACFP 810 First Street, N.E., Washington, DC 20002 – 3 rd Floor Grand Hall, Side A.

Claim Calculations and Recalculations in the CACFP

810 First Street, N.E., Washington, DC 20002 – 3rd Floor Grand Hall, Side A

Page 2: Claim Calculations and Recalculations in the CACFP 810 First Street, N.E., Washington, DC 20002 – 3 rd Floor Grand Hall, Side A.

Claims for Reimbursement

Page 3: Claim Calculations and Recalculations in the CACFP 810 First Street, N.E., Washington, DC 20002 – 3 rd Floor Grand Hall, Side A.

Claims for Reimbursement

How do CACFP payments work?

A. You’re paid a set amount in advance for the coming month.

B. You’re reimbursed a set amount for last month.

C. You’re reimbursed for the meals that you served last month.

D. You’re reimbursed for your actual costs last month.

Page 4: Claim Calculations and Recalculations in the CACFP 810 First Street, N.E., Washington, DC 20002 – 3 rd Floor Grand Hall, Side A.

Claims for Reimbursement

How do CACFP payments work?

A. You’re paid a set amount in advance for the coming month.

B. You’re reimbursed a set amount for last month.

C. You’re reimbursed for the meals that you served last month.

D. You’re reimbursed for your actual costs last month.

Page 5: Claim Calculations and Recalculations in the CACFP 810 First Street, N.E., Washington, DC 20002 – 3 rd Floor Grand Hall, Side A.

Claims for Reimbursement

What factors affect the amount of your claim payments?

1. The federal meal reimbursement rates

2. The reimbursement rate eligibility classifications (free / reduced-price / paid) for all participants

3. The number of meals served, by type (breakfast, snack, or lunch/supper)

Page 6: Claim Calculations and Recalculations in the CACFP 810 First Street, N.E., Washington, DC 20002 – 3 rd Floor Grand Hall, Side A.

Claims for Reimbursement

When do the reimbursement rates change?

A. January 1

B. July 1

C. October 1

D. Whenever Congress raises them

Page 7: Claim Calculations and Recalculations in the CACFP 810 First Street, N.E., Washington, DC 20002 – 3 rd Floor Grand Hall, Side A.

Claims for Reimbursement

When do the reimbursement rates change?

A. January 1

B. July 1

C. October 1

D. Whenever Congress raises them

Page 8: Claim Calculations and Recalculations in the CACFP 810 First Street, N.E., Washington, DC 20002 – 3 rd Floor Grand Hall, Side A.

Claims for Reimbursement

Why do the free / reduced-price / paid numbers matter?

The Blended Rate

Page 9: Claim Calculations and Recalculations in the CACFP 810 First Street, N.E., Washington, DC 20002 – 3 rd Floor Grand Hall, Side A.

 BREAKFAST

Free $1.58

Reduced $1.28

Paid $0.28

LUNCH / SUPPER

Free $2.93

Reduced $2.53

Paid $0.28

A.M. / P.M. SNACK

Free $0.80

Reduced $0.40

Paid $0.07

Claims for Reimbursement

The Blended Rate

Page 10: Claim Calculations and Recalculations in the CACFP 810 First Street, N.E., Washington, DC 20002 – 3 rd Floor Grand Hall, Side A.

Claim Payment Calculations

Page 11: Claim Calculations and Recalculations in the CACFP 810 First Street, N.E., Washington, DC 20002 – 3 rd Floor Grand Hall, Side A.

See “Reimbursement Calculator” Excel Spreadsheet

Page 12: Claim Calculations and Recalculations in the CACFP 810 First Street, N.E., Washington, DC 20002 – 3 rd Floor Grand Hall, Side A.

Claim Reimbursement Calculator

• Programmed with the basic federal reimbursement rates

• Mirrors the fields of the Claim for Reimbursement

• Shows your institution’s unique blended reimbursement rate for each meal type for the month

• Gives you an estimate of your monthly claim based on the reported free / reduced-price / paid numbers and number of meals served

Page 13: Claim Calculations and Recalculations in the CACFP 810 First Street, N.E., Washington, DC 20002 – 3 rd Floor Grand Hall, Side A.

Claim Reimbursement Calculator

• Play around with the calculator to see how the blended rate works– The percentage of participants in each

eligibility category, not the raw number, affects the blended rate• A higher percentage of participants in the “free”

category makes the blended rate closer to the “free” reimbursement rate for each meal type

– The number of each meal type served does directly affect the value of your claim payment

Page 14: Claim Calculations and Recalculations in the CACFP 810 First Street, N.E., Washington, DC 20002 – 3 rd Floor Grand Hall, Side A.

Claim Reimbursement Calculator

• The free / reduced-price / paid numbers do not affect the cash-in-lieu of commodity reimbursement rate• The cash-in-lieu of commodity reimbursement rate is

added to your blended rate for lunches and suppers

– All at-risk meals are reimbursed at the free reimbursement rate

Page 15: Claim Calculations and Recalculations in the CACFP 810 First Street, N.E., Washington, DC 20002 – 3 rd Floor Grand Hall, Side A.

See “Claim Calculation-Recalculation Example” Excel Spreadsheet

Page 16: Claim Calculations and Recalculations in the CACFP 810 First Street, N.E., Washington, DC 20002 – 3 rd Floor Grand Hall, Side A.

Claim Recalculation Spreadsheet

• Sent with review letters any time findings lead to fiscal action / claim recalculations

• Shows the data originally reported on the claim for each month and the value of that claim

• Shows the revised data, as determined by the State Agency, and the revised value of the claim

Page 17: Claim Calculations and Recalculations in the CACFP 810 First Street, N.E., Washington, DC 20002 – 3 rd Floor Grand Hall, Side A.

Claim Recalculation Spreadsheet

• State Agency focuses on the records and data for a “test month” during a review– Meals are typically only disallowed for the test

month

• Any IES classification errors are corrected for the entire fiscal year (going back to the month the child enrolled or was first claimed, or October -- whichever is later) – IES errors quickly add up over time

Page 18: Claim Calculations and Recalculations in the CACFP 810 First Street, N.E., Washington, DC 20002 – 3 rd Floor Grand Hall, Side A.

Reasons for Recalculations

• IES was misclassified • IES was correct but claimed incorrectly*• Incorrect number of participants reported in

the free/reduced-price/paid section*• Incorrect meal count totaling• Discrepancies between attendance and meal

counts (more meals claimed than people present)

• Meals/menus did not meet meal pattern

*Usually due to errors on the MEL


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