October 5, 2018
LEA Ad-Hoc Advisory Workgroup Publishes August 2018 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 August 1, 2018 meeting minutes include:
The Annual Report for FY 2017/18 has been posted to the DHCS website. No...
August 8, 2018
LEA Ad-Hoc Advisory Workgroup Publishes June 2018 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 6, 2018 meeting minutes include:
All LEA's Data Use Agreements (DUA) with DHCS are set to expire December 1,...
July 6, 2018
LEA Ad-Hoc Advisory Workgroup Publishes April 2018 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 April 4, 2018 meeting minutes include:
OIG (the federal Office of Inspector General) is auditing the LEA Billing...
June 18, 2018
DHCS Rolls Out New Authorization Requirements for the LEA Billing Program
On June 1, 2018, DHCS released their long-awaited new policy which will require all practitioners who order, refer, or prescribe (ORP) treatment services billed under the LEA Billing program to obtain a National Provider Identification (NPI) number and be separately enrolled in Medi-Cal.
Effective for all dates of service on July 1, 2018 and later, PPL 18-018 includes additional details about...
November 28, 2017
Federal Audit of New Jersey School-Based Medicaid Programs Seeks $300M in Paybacks
The federal Office of Inspector General (OIG) released audit findings of New Jersey's school-based Medicaid programs in which they request the state refund over $300 million.
Specifically, OIG determined:
PCG, the state's contractor, improperly altered school employees’ responses to timestudies to indicate that their activities were directly related to providing Medicaid services when...
October 2, 2017
UPDATED: DHCS Clarifies Position, Expressly Allows OT & PT Treatment Services Prescribed by LEA-Contracted Physicians
**Update as of October 2, 2017**
Since this post was originally published, DHCS has extended the 6-month renewal requirement to an annual renewal requirement for OT and PT prescriptions.
The announcement was made in an email from DHCS to LEAs on September 27, 2017, stating: "On August 24, 2017, DHCS sent the above policy update, with an additional requirement that prescriptions for PT/OT...
November 30, 2016
New Laws Impacting California’s School Medicaid Programs
Throughout the year, Paradigm tracks various state bills that have the potential to impact California's school-based Medicaid programs and publishes a summary of those that have been signed into law and those that failed to make the cut.
Click here to download our School Medicaid Report: 2015/16 Legislative Review & Program Impact....
October 31, 2016
OIG Publishes New State Audits of School-Based Medicaid Programs
The federal Office of Inspector General (OIG) has published new audit reports of school-based administrative and health services programs in North Carolina and Michigan.
Random Moment Time Sampling (RMTS) continues to be a focus of OIG school-based program audits but the impact of these findings vary from state to state, as they do in the two reports released earlier this month. Concerns have...
September 29, 2016
Governor Vetoes Senate Bill 123, SMAA Program Improvements
Governor Jerry Brown has vetoed Senate Bill 123, a bill authored by Senator Carol Liu to legislate recommendations by the State Auditor aimed at improving California's school-based Medi-Cal Administrative Activities (SMAA) program.
Senator Liu's office has expressed disappointment but also noted that the hard work to improve California's SMAA program, and the students and families who benefit...
September 21, 2016
RMTS for LEA Billing — Implementation Advisory Group Publishes September Meeting Summary
The Implementation Advisory Group (IAG) has published minutes from their September 13, 2016 meeting, which included a review of the draft State Plan Amendment and RMTS-related training slides for the Fall LEA Program training, scheduled for October 13, 2016.
If you are not yet registered for the upcoming DHCS Fall LEA Program training, which will be hosted via web conferencing, click here...