California DHCS Provides Update on School MAA Program Deferral and Interim Claiming Plan

On April 18, 2013, the California Department of Health Care Services (DHCS) emailed an update to regional agencies regarding the ongoing school Medi-Cal Administrative Activities (MAA) program deferral.

A summary of updates contained in the letter are outlined below. DHCS has a conference call scheduled with the federal Centers for Medicare and Medicaid Services (CMS) on Tuesday May 7, 2013 to discuss the ongoing deferral and interim claiming process.

Deferred Claims

  1. DHCS is currently developing a progress report on received deferral certifications and will share that report with the regional agency Co-Chairs once it is completed.  This information can then be shared with all regional agency coordinators and participating school claiming units.
  2. There are currently 920 school claiming units that are required to submit a deferral certification for CMS approval. DHCS has received 665 certifications and submitted 251 to CMS for review and approval; CMS has approved 54 deferral certifications and released those schools claiming units from deferral. Note: the total number of school claiming units requiring certification is higher than original estimates posted to the Policy Center.
  3. DHCS is continuing to process deferral certifications and submit these to CMS for approval.

Interim Claiming Plan

  1. DHCS has submitted a request to CMS to extend the interim claiming process through FY 2013-14, until a revised statewide claiming plan and new time study methodology is approved.
  2. The plan for a new school MAA program claiming methodology is currently with CMS. The first draft plan was submitted to CMS on October 4, 2012.  CMS sent comments on the methodology and plan to DHCS on December 6, 2012 and responses to these comments were sent to CMS on April 5, 2013.

DHCS states that their goal is to get all claiming units released from the deferral as quickly as possible. As additional information is made available by the department, we will continue to post updates to the Policy Center.

Stay Informed

As information on the deferral becomes publicly available, we will continue to post updates to the Policy Center. All archived news, events, publications and reference materials related to the deferral can be found on our Issue Analysis page devoted to this topic. Paradigm clients should refer to regular email communications and bulletins for operational guidance and additional details on this evolving situation.

Read More

Read the CMS Notice to California regarding the school MAA claims deferral…

Read our complete issue analysis of California’s school MAA program deferral, including all related news posts, publications, and source documents…