CMS Approves California SPA 05-010, Removing Supervision Requirements for Credentialed SLPs

Sacramento, CA – December 16, 2011 – The California Department of Health Care Services (DHCS) has received approval for State Plan Amendment (SPA) 05-010 from the federal Centers for Medicare and Medicaid Services (CMS). This amendment removes the supervision requirements for certain credentialed speech-language pathologists under the LEA Billing program and is back-dated to October 1, 2009.*

DHCS has received long-awaited approval for SPA 05-010, an amendment to California’s State Plan which implements equivalency for preliminary and professional clear credentials in speech-language pathology with the federal standards governing Medicaid reimbursement. As such, CMS has approved the removal of supervision requirements for preliminary and professional clear credentialed speech-language pathologists (SLPs) under the LEA Billing program, a big step in the efforts of DHCS and the LEA Ad-Hoc Workgroup to enhance LEA Billing program benefits.

Equivalency was first established in 2006, a result of an opinion published by the California Attorney General (AG) on the heels of California legislation that established new educational and work requirements for preliminary and professional clear SLP credentials. In an opinion issued by the California AG in November 2006, it was made clear that in California the credentialing requirements for SLPs with preliminary or professional clear services credentials (as defined by Education Code Section 44265.3) are equivalent to the federal credentialing standards and requirements.

Following the Attorney General opinion, DHCS and the LEA Ad-Hoc Workgroup began working to incorporate the ruling into a SPA, establishing equivalency and removing the supervision restrictions on credentialed SLPs billing for services under the LEA Billing program in California.

It is anticipated that the final approved language for SPA 05-010, as well as implementation guidance, will be released by DHCS shortly. We will post ongoing updates as the details of implementation continue to unfold. Feel free to contact Paradigm via email or phone, (888) 536-0920, with any questions.

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* The final SPA language, uploaded to the DHCS website on January 9, 2012, included a change in effective date from July 1, 2011 (which was listed on the original copy of the approval letter released in late December) to October 1, 2009.