RMTS for LEA Billing—Implementation Advisory Group Publishes October Meeting Summary

The Implementation Advisory Group (IAG) has published minutes from their October 3, 2017 meeting. Of interest: Navigant presented the technical RMTS “Wish List” items that were discussed during previous IAG meetings. The IAG discussed these items with DHCS and asked for them to be considered in the upcoming RMTS software system Request for Proposal (RFP). The LECs in attendance stated...

LEA Ad-Hoc Advisory Workgroup Publishes August 2017 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 August 2, 2017 meeting include: Dr. Lindy Summers-Bair of the Medical Review Branch retired as of July 31, 2017....

Federal Audit of New Jersey School-Based Medicaid Programs Seeks $300M in Paybacks

The federal Office of Inspector General (OIG) released audit findings of New Jersey's school-based Medicaid programs in which they request the state refund over $300 million. Specifically, OIG determined: PCG, the state's contractor, improperly altered school employees’ responses to timestudies to indicate that their activities were directly related to providing Medicaid services when...

November Medi-Cal Bulletin for LEAs Posted—RTD Generation Phasing Out Over Next 12 Months

The November Medi-Cal Bulletin for California LEAs has been published to the DHCS website. One item of interest is the announcement that DHCS will be discontinuing the generation of Resubmission Turnaround Documents (RTDs) over the next 12 months. The discontinuation will happen in multiple phases, with a timeline to be published in a future monthly bulletin. DHCS notes, "the new process...

Register by November 22 for Next LEA Advisory Workgroup Meeting

LEAs interested in attending the bi-monthly LEA Advisory Workgroup meeting (also known as the 'LEA Ad-Hoc Meeting') should RSVP to Cheryl Ward at DHCS by Wednesday, November 22, 2017. The meeting will take place on December 13, 2017 from 10:30 a.m. - 3:30 p.m. at Natomas Unified School District in the Staff Development Room, 1931 Arena Boulevard, in Sacramento. Previous meeting notes and...

SDUSD Makes the Case for School Health Services

Michelle Bell, a longtime member of our school Medicaid billing community, was recently featured in an article about the impact of school health services on the students in San Diego Unified School District. We're proud to work alongside Michelle and grateful for the attention she brings to the importance of school health services and programs on a daily basis. The article was published by...

New Resource for LEAs & Parents Regarding EOBs for School Health Services

DHCS has published a one-page informational that LEAs can share with parents regarding private insurance, explanation of benefits (EOB) statement for school health services, and impact to public benefits. When a child has both Medi-Cal and Other Health Coverage (OHC) through private insurance, and a school is billing Medi-Cal for eligible health services provided to that student under the LEA...

UPDATED: DHCS Clarifies Position, Expressly Allows OT & PT Treatment Services Prescribed by LEA-Contracted Physicians

**Update as of October 2, 2017** Since this post was originally published, DHCS has extended the 6-month renewal requirement to an annual renewal requirement for OT and PT prescriptions. The announcement was made in an email from DHCS to LEAs on September 27, 2017, stating: "On August 24, 2017, DHCS sent the above policy update, with an additional requirement that prescriptions for PT/OT...

2017 California Legislation: What Passed & What Didn’t

In September, several bills with possible implications for school health programs under consideration by the California Legislature were either suspended or passed and signed into law by the Governor.  Two bills with direct implications for the SMAA and LEA Billing programs, AB 834 and AB 481, both failed to pass out of committee. Read on for a brief summary of what passed, what didn't, and...

Save the Date: SMAA RMTS Coder Training

The California Department of Health Care Services (DHCS) has announced their annual SMAA RMTS Coder Training webinar which will be open to all program coordinators and stakeholders. Date: Thursday, October  12, 2017 Time: 1:30-3:00pm PST Location: this training will be hosted online via webinar Click here to register