CMS Gives Informal Approval for Interim School MAA Claiming in California

California’s Department of Health Care Services (DHCS) posted another school MAA (SMAA) program update to their website on September 17, 2013. The update confirms that DHCS has received informal approval from the Centers for Medicare and Medicaid Services (CMS) on several key issues related to the ongoing SMAA program deferral and development of a new claiming plan:

  1. SMAA Time Survey for FY 2013/14 – informal approval was granted for interim claiming in FY 2013/14, to be based on the previously approved program (2003). While this suggests a continuation of the time survey for the current fiscal year, details regarding training requirements or a Q2 time survey week have not yet been released. The state anticipates posting another update on this by the end of the month.
  2. Deferred Claims – informal approval was granted for the application of a reasonableness test criteria (RTC) to all deferred invoices and invoices for FY 2012/13. Once a formal approval is granted by CMS, DHCS will conduct a training on this process for participating school districts and their regional agencies. This suggests that, in addition to the certifications that school districts and claiming units have already completed, there may be additional steps that will need to be taken to release claims.
  3. Random Moment Time Study (RMTS) – informal approval was also granted for the timeline of specific milestones that must be met to ensure a new claiming plan is in place for FY 2014/15. DHCS has formed a state RMTS Workgroup which will meet several times through October and assist in the development of a new statewide claiming plan and time survey methodology for California. The Workgroup is comprised of stakeholders from various perspectives, including two representatives from both the Local Educational Consortium (LEC) and Local Governmental Agency (LGA) regional agencies, select school district claiming units, and DHCS.

 

While a resolution to the ongoing SMAA program issues has not yet been formally approved, DHCS has stated that they anticipate formal approval from CMS by the end of September 2013.

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Read the most recent DHCS SMAA program update, dated September 17, 2013…

View the DHCS SMAA “What’s New” webpage for all program updates…