LEA Ad-Hoc Advisory Workgroup Publishes June 2018 Meeting Minutes

The LEA Ad-Hoc Advisory Workgroup, comprised of LEA representatives, DHCS, and the California Department of Education (CDE), held their regularly scheduled meeting to make recommendations and discuss issues impacting the LEA Medi-Cal Billing Option Program. Highlights from the June 6, 2018 meeting minutes include: All LEA's Data Use Agreements (DUA) with DHCS are set to expire December 1,...

July Medi-Cal Bulletin for LEAs Posted – LEA Provider Manual Updates

The July Medi-Cal Bulletin for LEAs has been published to the DHCS website. One item of interest are updates to the LEA Provider Manual that reflect the change in withhold percentage from 1.5% to 2% and adding the location of service to the list of items that must be documented for all services (Paradigm clients, we have you covered here and there is no action required on your part). For...

June Medi-Cal Bulletin for LEAs Posted – Updated Withhold Percentage & OT/PT Benefits Update

The June Medi-Cal Bulletin for LEAs has been published to the DHCS website. Two items of interest include: Effective for dates of service on or after July 1, 2018, the 1.5 percent withhold levied against Local Educational Agency (LEA) reimbursements, which covers audit administration and associated audit costs, is increased to 2 percent. The 1 percent administrative withhold for claims...

LEA Ad-Hoc Advisory Workgroup Publishes April 2018 Meeting Minutes

The LEA Ad-Hoc Advisory Workgroup, comprised of LEA representatives, DHCS, and the California Department of Education (CDE), held their regularly scheduled meeting to make recommendations and discuss issues impacting the LEA Medi-Cal Billing Option Program. Highlights from the April 4, 2018 meeting minutes include: OIG (the federal Office of Inspector General) is auditing the LEA Billing...

DHCS Rolls Out New Authorization Requirements for the LEA Billing Program

On June 1, 2018, DHCS released their long-awaited new policy which will require all practitioners who order, refer, or prescribe (ORP) treatment services billed under the LEA Billing program to obtain a National Provider Identification (NPI) number and be separately enrolled in Medi-Cal. Effective for all dates of service on July 1, 2018 and later, PPL 18-018 includes additional details about...

National Research Project Needs Your Input

The American Federation of Teachers (AFT) is conducting research into school Medicaid programs across the country in an effort to collect data on how schools and districts leverage Medicaid billing for student health. If you are a program coordinator and would like to participate, or just learn more about the research project, follow the link below. The study takes just shy of 30 minutes to...

LEA Ad-Hoc Advisory Workgroup Publishes February 2018 Meeting Minutes

The LEA Ad-Hoc Advisory Workgroup, comprised of LEA representatives, DHCS, and the California Department of Education (CDE), held their regularly scheduled meeting to make recommendations and discuss issues impacting the LEA Medi-Cal Billing Option Program. Highlights from the February 7, 2018 meeting minutes include: A confirmation that when RMTS rolls into the LEA Billing program, Code...

Healthy Schools Campaign Hosting Webinar on Free Care

**This post has been updated to include a link to the webinar recording** Date: Wednesday, February 28, 2018 Time: 11am-12pm PST Register: Closed   About the event: The change in the free care policy presents an important opportunity to increase access to and resources for school health services. While the December 2014 State Medicaid Director letter clarified that school...

Federal Government Set to Reopen with Temporary Funding Bill through Feb. 8

This morning, the U.S. Senate passed a temporary funding bill to pave the way for keeping the federal government open through February 8, 2018. The bill still needs to pass the U.S. House, and is expected to do so easily. A permanent funding bill would need to be passed prior to February 8 to avoid another shutdown. As previously reported, we do not anticipate any impact to school-Medicaid...

Will a government shutdown impact school-Medicaid payments?

As the deadline looms for the federal government to approve funding for the fiscal year and avoid a shutdown, school-Medicaid stakeholders may be wondering what impact a shutdown would have on their programs. It doesn't appear that Medicaid payments will be affected by a temporary shutdown.  Several Federal congressional legislators have already identified on their websites that Medicare,...