CMS Requests Additional Information Regarding SPA 15-021

CMS has issued a request for additional information (RAI) regarding California’s state plan amendment, (SPA) 15-021, which proposes several changes and expansions to the LEA Medi-Cal Billing Option Program. This is fairly common in the SPA approval process (some of you may remember that it took nearly two years to gain approval for the last LEA Billing state plan amendment,  SPA 03-024, back in 2003).

This request for additional information stops the 90-day clock for CMS to take action on the SPA. DHCS has 90 days to respond with additional information or an alternate action plan, at which point a new 90-day clock will begin for CMS.

SPA 15-021 proposes to add new assessment and treatment services, new practitioner types, incorporate RMTS into the LEA Billing program, and implement guidance to allow non-IEP and non-IFSP service billing in accordance with CMS’ reversal of the free care rule last December.

You can read more about the details of SPA 15-021 in our earlier post. DHCS is accepting comments or questions regarding the SPA process and CMS’ request for additional information via their inbox, (include “SPA 15-021 RAIs” in the subject line).