Alert: Two SMAA Claiming Units Released from Deferment by DHCS and CMS

Paradigm is pleased to announce that two of its clients will soon be receiving payment for MAA invoices that were subject to certification as part of a statewide federal payment deferral (put into effect this past June).


October 29, 2012 – San Francisco, CA – This past June the Centers for Medicare and Medicaid Services (CMS) asked the state of California to re-evaluate unpaid School Medi-Cal Administrative Activities (SMAA) claims and to change the reimbursement program’s claiming methodology for fiscal year 2012/13. As a result, the payment of approximately $66 million in school MAA claims (statewide) was deferred.

Paradigm has received confirmation that two of its clients’ claiming units have been released from deferral following the approval of their SMAA Invoice Supporting Documentation by both the state and CMS.  This means their MAA invoices are now cleared for processing and payment, marking the first release of claiming units since the announcement of the federal payment deferral in June. We hope this is the beginning of a steady stream of approvals for California Local Educational Agencies (LEAs). We commend both the state and CMS for acting quickly to review and certify claims for LEAs that are anxiously awaiting payment.

As background, in August the state issued instructions to California LEAs on providing supporting documentation to validate and certify their SMAA invoices. The supporting documentation was to be reviewed by regional agencies, the state, and CMS.  Following an approval, this would result in a release of the claiming unit for invoice processing and payment of MAA claims.  Once the instructions were released, Paradigm acted quickly by organizing and assisting its clients with gathering their information. We also provided our clients with a framework in which to effectively address the questions being posed in the certification. We are thrilled that two of our clients are the first to receive approval based on their supporting documentation—demonstrating the commitment our clients have to the integrity of their school Medicaid programs, and our commitment to fostering supportive partnerships that focus on the importance of LEAs being in-the-know and in control of their own programs.

Congratulations to Mendocino County Office of Education, Lake County Office of Education, and their regional agency, Sonoma LEC. Their ability to quickly demonstrate their compliance with program regulations and intent of the program is evidence of the commitment and years of hard work their staff invested in their local MAA programs.

If you have any questions please feel free to contact us via email or by phone at (888) 536-0920.