LEA Ad-Hoc Advisory Workgroup Publishes June 2017 Meeting Minutes

The LEA Ad-Hoc Advisory Workgroup, comprised of LEA representatives, DHCS, and the California Department of Education (CDE), held their regularly scheduled meeting to make recommendations and discuss issues impacting the LEA Medi-Cal Billing Option Program.

Highlights from the June 7, 2017 meeting include:

  • In April 2017, DHCS posted the finalized Annual Accounting of Funds Summary Report for FY 2014-15 on the LEA BOP website under Claims Processing. DHCS has drafted an Operating Instruction Letter (OIL) instructing the fiscal intermediary to:
    • Refund $2,254,297 to LEAs over-collected for the A&I and NCI withholds in FY 2014-15, including a reconciliation of the 1% Administrative withhold due to Remittance Advice Details (RADs) 710, 728 and 769 (cost settlement, other than cost settlement and Electronic Health Records)
    • Collect via offset $79,467 from LEAs that were under-collected for the A&I and NCI withhold in FY 2014-15 or were under-collected due to not being assessed the 1% Administrative withhold in FY 2014-15
  • Sometime this Fall, an Erroneous Payment Correction (EPC) will be initiated to reprocess claims submitted by LEAs for Date of Service (DOS) July 1, 2016 through June 30, 2017, using updated reimbursement rates for LEA services. This is because the annual rate inflation adjustment based on the Implicit Price Deflator has been calculated at 1.73% for FY 2016-17.
  • DHCS Safety Net Finance Division (SNFD), A&I FAB and the Medical Review Branch (MRB) held a quarterly meeting June 2, 2017. This meeting included a general discussion on trends and audit findings, which have remained consistent with prior audit findings. The information on common audit findings will be included in future training materials.
  • SNFD is in the process of updating the Transportation Guide and Training Slides to reflect Specialized Medical Transportation provided in a specially adapted vehicle or vehicle that contains specialized equipment, including but not limited to lifts, ramps, or restraints, to accommodate the LEA eligible beneficiary’s disability. DHCS reminded the LEAs to collect back-up documentation for transportation services, since the future CRCS for State Plan Amendment (SPA) 15-021 will reconcile transportation costs, depreciation, and other related transportation costs that are not currently being captured in the CRCS.
  • A LEA asked, how RMTS will work for the following: contracted staff, staff paid on a per diem, and staff on a reduced schedule. NCI stated that contract employees are not included in the RMTS, but they can still bill for services. NCI also stated that reduced schedule employees will need to be included in the RMTS, if they are not contracted. DHCS and NCI must complete more research regarding per diem employees, and will provide additional information in training sessions.
  • DHCS stated that they have a draft of the Provider Manual updates for IHSPs; however, until the SPA is approved it cannot be published. Once the SPA is approved, the policy will take effect. DHCS will send a copy of the draft Provider Manual updates to the Documentation Subcommittee. This relates to the ongoing implementation and determination of audit requirements for billing non-IEP (‘free care’) services.

At the time of posting, the August 2, 2017 Ad-Hoc meeting has already taken place. Notes on this meeting should be published by DHCS in the coming months.

For information on attending the next meeting, LEAs should contact the LEA Inbox at LEA@dhcs.ca.gov.

Past LEA Ad-Hoc Advisory Workgroup meeting minutes are archived on the DHCS website.