RMTS for LEA Billing — Implementation Advisory Group Publishes March Meeting Summary

The Implementation Advisory Group (IAG) provided the following updates from their March 1, 2016 meeting:

  • DHCS has submitted the first phase of responses to CMS’ Request for Additional Information (RAI).
  • DHCS and CMS will hold a conference call mid-March to discuss the Department’s Phase I responses.
  • DHCS received several points of feedback from program coordinators and other stakeholders that was discussed during the meeting, including:
    • Auditing Code 2 Moments — when asked whether direct health service moments coded to Code 2 will be subject to audit for medical necessity, DHCS stated that they have not yet discussed auditing of moments with CMS and whether or not this will be a program requirement on the LEA Billing side. DHCS will provide additional information as it becomes available.
    • Abnormal Work Schedules — a stakeholder brought up the issue of RMTS software constraints with regard to staff who work abnormal schedules (a scenario that would make participation in the SMAA RMTS difficult). This issue was noted by the IAG and will be added to their list of technical implementation issues to address in the LEA-RMTS implementation.
    • Ensuring RMTS Software QA — when asked about what measures DHCS will take to oversee and monitor the RMTS software to ensure that it is performing is accordance with program requirements, the IAG stated that they would take these questions into consideration in the LEA-RMTS implementation. The group would like to see DHCS’ plan made publicly available.
    • Tape-Match — when asked about the impact of a new SMAA tape-match process, DHCS stated that their LEA Program staff are working with the SMAA Program staff to gather more information on how this process will impact LEA providers.

 

The next meeting is set for April 5, 2016.

Feedback for the IAG, including questions or concerns, can be submitted using the online Stakeholder Feedback Tool.

 

About the Implementation Advisory Group: The IAG is a a curated group of stakeholders that are working to address issues related to the transition of the LEA Medi-Cal Billing Option Program to RMTS. See the IAG’s RMTS Quick Profile Page for a general summary of how RMTS will be incorporated into the LEA program.