California Changes Policy to Allow Claiming of Staff Funded with LEA Billing Reimbursements on MAA Invoice

On July 13, 2011, the California Department of Health Care Services (DHCS) released PPL 11-013, notifying LEAs who participate in both the LEA Direct Billing and School-Based MAA (California’s Medicaid Administrative Claiming program) programs that staff funded with LEA Billing reimbursements may now be included on the MAA invoice and CRCS report. This policy change takes effect immediately, meaning staff whose costs are funded with LEA Billing reimbursements can be included on the 10/11 MAA invoices.

LEAs can now ‘claim’ expenditures made with LEA Billing reimbursements, identified as resource code 5640 in the standardized accounting code structure (SACS), on MAA invoices. PPL 11-013 also impacts allowable costs for Cost and Reimbursement Comparison Schedule (CRCS) reports, and can be applied starting with 09/10 reports. It is important to note that these changes do not alter the restrictions on how LEAs reinvest LEA Billing reimbursements. In California, reimbursements must supplement, not supplant, existing funds for school and health programs.

Paradigm’s News Release No. 027 to clients highlighted DHCS’s intention to change the policy concerning 5640 funds in February 2011. A review of available data has indicated that LEAs in California could see as much as a 20% increase in their MAA claims as a result of this policy change. Our staff is honored to have been involved in the process and the resultant positive change along with other advocates such as the California School Health Centers Association and Partnership for Children and Youth. We are thankful for the efforts made by the LEA Ad-Hoc Committee who worked closely with both DHCS and CDE to bring about PPL 11-013, officially resolving this issue.

If you have any questions about this policy change, please contact the Policy Division at policy@paradigm-healthcare.com.