News: LEA Billing

PPL 21-040: Notification of Reimbursement for COVID-19 Vaccinations in the LEA Billing Program

PPL 21-040: Notification of Reimbursement for COVID-19 Vaccinations in the LEA Billing Program Last Wednesday, December 15, DHCS released an email regarding Policy and Procedure Letter 21-040 titled “Notification of Reimbursement for COVID-19 Vaccinations in the LEA Billing Program.” This may be…

PPL 21-015: Unsatisfactory Immigration Status Beneficiaries in the LEA Billing Program

PPL 21-015: Unsatisfactory Immigration Status Beneficiaries in the LEA Billing Program On July 16, DHCS released an email regarding Policy and Procedure Letter (PPL) 21-015 titled, “Unsatisfactory Immigration Status Beneficiaries in the LEA Medi-Cal Billing Option Program.” This PPL, dated June…

Enacted 2021/22 State Budget

Enacted 2021/22 State Budget On July 9, the 2021/22 California Budget was passed and signed. In it, the proposed budget request submitted by DHCS back in April, specific to the LEA program expansion was included. The budget approves eight permanent positions and expenditure authority of over $2.2…

LEA Billing Program: TSP Lists for Consortiums

LEA Billing Program: TSP Lists for Consortiums On Monday, November 23, 2020, DHCS sent out an email providing direction on how the Time Survey Participant (TSP) List should be developed for LEAs that are part of a billing consortium under the LEA Billing program. According to the email, DHCS…

State Plan Amendment (SPA) 16-001 Targeted Case Management Services

On Thursday, October 22, 2020, DHCS announced that the Centers for Medicare and Medicaid Services approved State Plan Amendment (SPA) 16-001, with an effective date of January 2, 2016. For California LEAs billing for Targeted Case Management (TCM) services, SPA 16-001 now allows for TCM services to…

Roundup of Recently Published PPLs for California’s LEA Billing Program

California Department of Health Care Services (DHCS) has sent out another round of LEA Billing Policy and Procedure Letters (PPLs) as it continues to solidify implementation of State Plan Amendment 15-021. Paradigm’s roundup is below, including key takeaways. PPL 20-038, August 11 – Increase in…

LEA Billing Program Legislative Report FY 2018/19

As part of a requirement to submit annual reports to the California Legislature on the state of the LEA Medi-Cal Billing Option program, DHCS published their 2018/19 report on August 14, 2020. Information in this most recent Report to Legislature covers a wide range of topics, including a…

PPL 20-031: Random Moment Time Survey (RMTS) Participant Equivalency Process

On Friday, July 31, 2020, California DHCS released PPL No. 20-031 outlining the process and requirements for its RMTS Time Survey Participant (TSP) List Equivalency Request for LEA Billing purposes. This is good news for LEAs with providers who perform direct medical services as a primary job…

PPL 20-023: Submitting Quarterly Random Moment Time Survey (RMTS) Percentage Results to the Department of Health Care Services (DHCS)

On Tuesday, July 7, 2020, DHCS published Policy & Procedure Letter 20-023, titled “Submitting Quarterly Random Time Moment Survey (RMTS) Percentage Results to the Department of Health Care Services (DHCS)”. This PPL supersedes PPL 19-004R which was released in June, 2019 (click here for more on…

PPL 20-022: Notification of Random Moment Time Survey Requirement for the Local Educational Agency Medi-Cal Billing Option program

On Thursday, June 25, 2020, DHCS published Policy & Procedure Letter 20-022, titled "Notification of Random Moment Time Survey Requirement (RMTS) for the Local Educational Agency Medi-Cal Billing Option Program.” The information shared in this PPL 20-022 is specific to the changes that will…