July Medi-Cal Bulletin for LEAs Posted

The July 2019 Medi-Cal Bulletin for LEAs has been published to the DHCS website. It included an adjustment to the reimbursement rates for LEA Services for FY 2019/20. Click here to read the current or past Bulletins.

DHCS Posts PPL 19-015, Notification of Change to Physician Prescription Policy

On July 10, 2019, DHCS posted Policy and Procedure Letter (PPL) 19-015 stating that for services dated July 1, 2019, and forward, treatment authorizations (orders/prescriptions) signed by Physician Assistants (“PA”) or Nurse Practitioners (“NP”) are eligible. This means, for example, that the specialized procedure orders that in the past met the criteria but were signed by a PA or NP...

DHCS Releases Report with Final Results of SMAA Deferral & Backcasting Process

On June 28, 2019, DHCS sent out their final report on the results of the SMAA program deferral and backcasting process; results long-awaited by impacted California school districts. The distributed SMAA Report on Results of Backcasting of Deferred Claims includes an executive summary of the final results of this multi-year process, a history of the deferral, and a detailed table showing the...

DHCS Extends Deadline for FY 2017/18 Q3 SMAA Invoice Submissions

On Tuesday, June 25, 2019, DHCS sent an email to their SMAA mailing list issuing a 30-day extension for the FY 2017/18 Q3 invoices submissions for the SMAA program. The new submission due date is July 31, 2019.   Click here to subscribe to DHCS SMAA mailing list.

U.S. Department of Education Releases Final “Supplement, Not Supplant” Guidance for School Districts

On June 20, 2019, the U.S. Secretary of Education Betsy DeVos released final non-regulatory guidance to support school districts’ compliance with the requirement that federal funds supplement, and do not supplant, state and local funds. "Schools need to spend resources on what's best for students, not what's least likely to come up in an audit," said Secretary DeVos. The release of this final...

June Medi-Cal Bulletin for LEAs Posted

The June 2019 Medi-Cal Bulletin for LEAs has been published to the DHCS website. There was no LEA Billing program-specific information of note in this month's Bulletin. Click here to read the current or past Bulletins.

PPL 19-011R—Random Moment Time Survey (RMTS) Sampling Requirements—Now Available on DHCS Website

On June 13, 2019, DHCS published Policy and Procedure Letter (PPL) 19-011R Random Moment Time Survey (RMTS) Sampling Requirements to their website. This PPL confirms that, since a moment in RMTS is one minute in time, there should not be any moments issued during the final minute of a time survey participant’s (TSP) work schedule. DHCS gives the example that if a TSP is scheduled to work an...

DHCS Posts Training Slides and FAQs for Their LEA Medi-Cal Billing Program SPA 15-021 Implementation Training

DHCS held a State Plan Amendment (SPA) 15-021 implementation training in Southern California on April 22, 2019, and in Northern California on May 9, 2019. At the training, they confirmed that SPA 15-021 had not yet been approved by CMS and so all the training was pending that approval. On June 10, 2019, they posted the PowerPoint slides and FAQs. SPA 15-021 Implementation Training Slides ...

Highlights from LEA Ad-Hoc Advisory Workgroup June 2019 Meeting

On June 5, 2019, the California Department of Health Care Services (DHCS) held a meeting for the LEA Ad-Hoc Advisory Workgroup, comprised of LEA representatives, DHCS, and the California Department of Education (CDE); the meeting is held to make recommendations and discuss issues impacting the LEA Medi-Cal Billing Option Program. Highlights from the June meeting include: Erroneous Paid...

LEA Ad-Hoc Advisory Workgroup Publishes February 2019 Meeting Minutes

On June 11, 2019, DHCS posted February 6, 2019, meeting minutes for the LEA Ad-Hoc Advisory Workgroup, comprised of LEA representatives, DHCS, and the California Department of Education (CDE); the meeting is held to make recommendations and discuss issues impacting the LEA Medi-Cal Billing Option Program. Highlights from the February meeting included: Effective January 1, 2019, CPT Code...