DHCS Clarifies Policy on Claiming SMAA Participation Fees

DHCS released a Policy and Procedure Letter, (PPL) 16-007, clarifying the reimbursement requirements for participation fees related to the School-Based Medi-Cal Administrative Activities (SMAA) and County Medi-Cal Administrative Activities (CMAA) programs for Local Governmental Agency (LGA) and Local Educational Consortium (LEC) Coordinators.

PPL 16-007 does not constitute new policy or require any changes on the part of currently participating LEAs.

While this PPL is intended for LEC and LGA Coordinators, it is important for participating LEAs to remember that they may only claim fees paid to the regional agency if their LEC or LGA has informed them that the LEC or LGA is not claiming federal reimbursement for their own costs.

This is because federal reimbursement for costs to administer the programs can only be claimed once (to avoid ‘double dipping’); so, if an LEA’s LEC or LGA is claiming federal reimbursement for their costs, the LEA cannot also claim reimbursement for those same costs.

More information on the reimbursement requirements for LEAs can be found on pages 9-1 and 9-2 of the 2014-15 SMAA Manual; requirements for LECs and LGAs can be found in the recently published clarification PPL 16-007.