DHCS Releases Report with Final Results of SMAA Deferral & Backcasting Process

On June 28, 2019, DHCS sent out their final report on the results of the SMAA program deferral and backcasting process; results long-awaited by impacted California school districts. The distributed SMAA Report on Results of Backcasting of Deferred Claims includes an executive summary of the final results of this multi-year process, a history of the deferral, and a detailed table showing the...

DHCS Releases Vendor Fee Worksheets for Backcasting & RMTS Invoices

The Vendor Fee Worksheet (VFW), a new mechanism by which DHCS will ensure that LEAs can only claim (i.e. be reimbursed) for up to 15% of their total invoice amount in vendor fees, was released on August 2 after a months-long revision process by DHCS. This form was required to complete the first round of backcasted invoices from the SMAA deferral, as well as annually for RMTS claims starting...

SMAA Deadlines Extended and Backcasting Updates from DHCS

DHCS has published meeting minutes from their RMTS Workgroup meeting held on April 19, 2017. Of particular interest: SMAA invoice deadlines for 2015/16 Q1 and Q2 have been extended to July 31, 2017 and August 31, 2017 respectively Backcasting invoices for claims in excess of $25,000 from FY 2009/10 and 2010/11 are still due by June 30, 2017 (although work cannot begin until the final set...

School Districts Wait for Vital SMAA Program Information

School districts participating in California's School-Based Medi-Cal Administrative Activities (SMAA) Program, a federal reimbursement program that provides valuable funds that are reinvested back into the state and school district, continue to wait for information that may be central to their continued participation in the program. Specifically, California schools are anxiously waiting for...

Conditional Approval Received for Backcasting Years of Deferred Invoices

On October 28, 2015 federal Centers for Medicare & Medicaid Services (CMS) issued a letter to the California Department of Health Care Services (DHCS) conditionally approving their proposed backcasting plan to resolve years of deferred school-based MAA claims. DHCS had submitted a proposal that would essentially apply 4 quarters of random moment time study results to prior period costs to...

California Submits Backcasting Proposal to CMS

DHCS has moved forward with plans to implement a backcasting method for deferred claims after failing gain CMS approval for an alternate settlement to the deferral which would have avoided backcasting all together and paid claims based on a flat percentage. On April 1, DHCS submitted their backcasting proposal to CMS. Before this process can be finalized, CMS must approve all details of the...

CMS Rejects California’s Alternative SMAA Deferral Proposal

In a letter received by the California Department of Health Care Services (DHCS) on March 16, 2015, the federal Center for Medicare and Medicaid Services (CMS) rejected the state's most recent proposal to end the school MAA deferral with final settlement payments to schools and no backcasting requirement for past claims. CMS also asked that DHCS submit a backcasting proposal for their review by...

DHCS Submits Alternative Proposal to Resolve California’s SMAA Deferral

On February 20, 2015, California's Department of Health Care Services (DHCS) submitted a proposal to the federal Center for Medicare and Medicaid Services (CMS) that would bring a fair and swift end to the nearly three year long deferral of the school MAA program. Instead of submitting a proposal for backcasting, a method DHCS and CMS had agreed last October as the final means to settle the...

California’s New School MAA Program Likely Delayed Until January 1, 2015

California's Department of Health Care Services (DHCS) has reportedly received approval from the federal government to delay implementation of California's new school MAA program until the third quarter of the 2014/15 fiscal year. Although the state has yet to publish this announcement on their website, they have communicated the information to regional LECs and LGAs that, in turn, have begun to...