CPMA: Fiscal Intermediary FAQ's Listing

This section will provide answers to the following questions
(click on a question to jump-to the answer):

What is a fiscal intermediary?
What are the two employer options?
How do I choose Option One or Option Two?
Who hires the PCA?
What employer costs am I responsible for?
What are the personal care agency’s responsibilities?
What are the fiscal intermediary’s responsibilities?
What are my responsibilities?
Who chooses my fiscal intermediary?
What if I have problems with the fiscal intermediary?
How and when do I pay my PCAs?
When should I send in my Activity Form (timesheet)?
What hours are your machines available to receive faxes?
When can I find out if my fax was received?
How many hours each week can my PCAs work?
How does a PCA sign up for direct deposit?
How does a PCA get direct deposit without a bank account?
Will MassHealth pay my PCAs for overtime?
How do I request overtime pay for my PCAs?
Will MassHealth pay my PCAs for jury duty?
What if one of my PCAs gets injured on the job?
What if I have questions about my legal responsibilities as an employer?
How do I order forms (W-4, Direct Deposit Applications, etc.)?
What if I need more information?

What is a fiscal intermediary?
A fiscal intermediary is a company hired by MassHealth that can help you with the financial responsibilities of employing PCAs, 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 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.

Who hires the PCA?
If MassHealth approves PCA services for you, you must recruit, hire, fire, train and schedule your own PCAs. Remember, you are the employer in this program. Cerebral Palsy of Massachusetts 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)

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 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

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

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.

How and when do I pay my PCAs?
For Option One you can either:

have the fiscal intermediary deposit your PCAs’ checks directly into their bank account
(only if your PCAs agree)
or have the fiscal intermediary mail you or have available for pick up a check for each of your PCAs, which you must then give to your PCAs on time.

For Option Two the fiscal intermediary will mail a check to you or have a check available for pick up containing the money you will receive from MassHealth.

When should I send in my Activity Form (timesheet)?
Timesheets can be faxed to the fiscal intermediary on Sunday or Monday after the end of the payroll period. It is important to get the timesheets in as soon as possible to ensure the PCAs get paid on time. If you are mailing timesheets, place them in the mail on Sunday or Monday. Please understand that mailed timesheets may not arrive early enough to ensure your PCAs are paid on time. It is more efficient to fax the timesheets.

What hours are your machines available to receive faxes?
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 find out if my fax was received?
If you fax timesheets over the weekend or on Monday, we can tell you if we received the timesheet on Tuesday. If you fax a timesheet on Tuesday, Wednesday, Thursday or Friday, we can tell you the on day you fax the timesheet whether it was received.

How many hours each week can my PCAs work?
MassHealth will reimburse you only for the number of hours of PCA services MassHealth has approved. You must schedule your PCAs according to the number of hours approved by MassHealth.

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.

How does a PCA get direct deposit without a bank account?
The solution is Paychek Plus! Paychek Plus is a payroll debit card that allows the PCA to retrieve their funds from ATMs or make purchases at point-of-sale terminals nationwide- and you don’t need to open a bank account to enroll. The fees associated with the use of the card are minimal compared to most check cashing stores. Here are some of the benefits:
• Your debit card is a safer alternative to paper checks. No more checks lost in the mail.
• No more waiting one week from the check date to get a replacement for lost checks.
• No more waiting in lines to cash your checks.
• No more check cashing fees cutting in to your take home pay.
• Your cash is available at the nearest ATM or retail store to withdraw or make purchases.
• Safety- Carry only the cash you need.
• Get cash at over 1 million STAR or CIRRUS ATMs.
• Add money from other sources to your debit card account (another job, etc.)
• A low-cost way to send money to relatives- save 70% on traditional money transfers.
• The security of FDIC insurance.
Please print an application from this site to enroll in the debit card program.

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.

How do I request overtime pay for my PCAs?
If your regularly scheduled PCA is not available and the only PCA available will need to work for you more than 40 hours in one week, you must contact your personal care agency immediately to request overtime pay for that PCA. If it is a weekend, evening or holiday you can leave a message on the personal care agency’s answering machine. The personal care agency will contact MassHealth to request approval prior to payment of overtime. MassHealth will let you and the fiscal intermediary know in writing whether it has approved your request for overtime pay. MassHealth will still pay the regular rate if your request for overtime pay is not approved.

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.

What if I have questions about my legal responsibilities as an employer?
MassHealth, your personal care agency and your fiscal intermediary cannot give legal advice, but there are many other organizations that can help with your questions. Click Here for a list of organizations that can help you in your role as an employer. They may mail you information or give you advice over the telephone.

How do I order forms (W-4, Direct Deposit Applications, etc.)?
Please feel free to print any forms you need from this website or call our Customer Service Department and we will mail your requested forms.

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

Learn More >

Back to Home >