RMTS for LEA Billing – Implementation Advisory Group Publishes December Meeting Summary

The Implementation Advisory Group (IAG), 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, provided the following updates from their December 9, 2015 meeting:

  • DHCS is still waiting for CMS’ response to the initial submission of State Plan Amendment (SPA) 15-021, which was submitted on September 20, 2015. CMS has 90 says to respond to DHCS.
  • IAG discussed the pros and cons of a regional RMTS structure (as is currently employed in the SMAA Program) and a statewide RMTS structure (which is common in other states).
  • DHCS stated that they don’t plan to include edits to the SMAA Program manual that would set the stage for the inclusion of RMTS for LEA Billing. They indicated that any edits or changes that this transition requires will be added at a later date.
  • Discussed a proposed definition for Activity Code 2 that will account for the inclusion of LEA Billing-RMTS once SPA 15-021 is approved by CMS.
  • Discussed Targeted Case Management and a certification process for LEAs that will want to participate in both the TCM and LEA Billing programs.
  • IAG kicked off discussions regarding the planning, coordination, and prioritization of implementation issues and requirements.

The next meeting is set for January 12, 2016.

See the IAG’s RMTS Quick Profile Page for a general summary of how RMTS will be incorporated into the LEA program.

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