DHCS News Roundup

Over the past week, DHCS sent a handful of email announcements to LEAs regarding the operations of LEA BillingFor your information, the roundup is below: 

2017/18 CRCS Submission Docs Update  

On Sept. 27, 2019, DHCS posted the template documents for the 2017/18 CRCS. In addition, DHCS posted PPL 19-019 (Sept 18, 2019), which calls for a small change in how to submit your CRCS to DHCS. Rather than submitting a full PDF copy along with the Excel file, now, one only needs to send the signed “LEA Certification Page” (signature page) in PDF along with the completed CRCS in Excel. We say, no problem on that!  

Eligibility Tape Match 

On Sept. 24, 2019, DHCS sent a notice confirming that recent coding changes to the programming of the eligibility data match tool, “MOVEit,” may have impacted the output data files. (Translation: they may not have been totally accurate.) DHCS is working on correcting the issue; and, Paradigm is monitoring the issue closely and will post an update if we anticipate any negative impact—there is no such concern at this time. 

As an aside, on Sept. 30, 2019, DHCS also released PPL 19-020, which was directed to LEA Billing and SMAA stakeholders. This PPL looks to reiterate the (already known) requirements for submitted eligibility data match files.  

New Telehealth Modifier “95” Update 

DHCS sent an email to stakeholders on Sept. 27, 2019, confirming what was already published in August’s Medi-Cal Bulletin: telehealth claims should use the new modifier “95” for services dates on and after July 1, 2019The new news is that the rate table has been updated with this information. Paradigm is already compliant with this requirement and any telehealth services documented in our systems are being submitting with the appropriate identifier.  

Update to 2019/20 LEA Program Rate Tables 

In July, DHCS confirmed reimbursement rates for 2019/20 services have been increased to account for inflation. These increases are usual and customary in the program. DHCS’s Sept. 27, 2019, email was to confirm for all stakeholders that their rate table has been updated to reflect the new rates.