DHCS Clarifies Position, Expressly Allows OT & PT Treatment Services Prescribed by LEA-Contracted Physicians

Big news for California LEAs who have been waiting for clarification from the Department of Health Care Services (DHCS) regarding Occupational Therapy (OT) and Physical Therapy (PT) treatment services prescribed by LEA-employed or contracted physicians. In an email sent to program stakeholders on August 24, DHCS makes clear that prescriptions for OT and PT treatment services may come from...

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...

March Medi-Cal Bulletin for LEAs Posted – New Retroactive Adjustment for Under- and Over-Collection of Withholds

The March Medi-Cal Bulletin for California LEAs has been published to the DHCS website. One item of interest is an announcement regarding a retroactive adjustment of LEA claims due to under- and over-collection on withholds back to July 2011. DHCS has confirmed that these are related to the administrative fees withheld and capped at an annual maximum, also stating that most of the...

Two-decade old legal battle over special education oversight nears resolution, brings major changes – EdSource

"The California Department of Education said last week that it will comply with a federal court order to improve significantly its system for monitoring special education, after years of legal maneuvering to block the changes.... The changes in monitoring come as California is taking steps to address a root concern about special education services statewide: why many students with...

Advisory Panel Finalizing School Health Recommendations to DHCS

The Medi-Cal Children's Health Advisory Panel (MCHAP) will be meeting on April 18, 2017 to finalize their recommendations to the Department of Health Care Services (DHCS) on children's behavioral health care, including strengthening school-based health services through the SMAA and LEA programs. The most recent draft of MCHAP's recommendations call on DHCS to work more collaboratively with...

Register by March 17 for Next LEA Advisory Workgroup Meeting

LEAs interested in attending the bi-monthly LEA Advisory Workgroup meeting (also known as the 'LEA Ad-Hoc Meeting') should RSVP to Cheryl Ward at DHCS by Friday, March 17, 2017. The meeting will take place from 10:30 a.m. - 3:30 p.m. at Natomas Unified School District in the Staff Development Room, 1931 Arena Boulevard, in Sacramento. Previous meeting notes and agendas can be found on the...

New DHCS Guidance for LEAs Regarding Insurance Carrier Requests

DHCS has released a statement for LEAs who have received communication from private health insurers regarding school health service claims. Over the past year, several LEAs have reported receiving information from private insurers part as of the state's transition to the practice of pay and chase for students with both Medi-Cal and Other Health Coverage (OHC). On March 9, 2017, DHCS emailed...

Bills We’re Tracking: 2017 California Legislation

Two bills have been introduced in the California Legislature for the 2017-18 session that directly relate to the School-Based Medi-Cal Administrative Activities (SMAA) and LEA Medi-Cal Billing Option programs. Both bills carry language similar to what was proposed under the Senate Bill (SB) 123, which was vetoed by the Governor last September. We'll be tracking these bills as they are amended...

DHCS Publishes New LEA Billing FAQs

As a follow-up from the Fall 2016 LEA Billing DHCS training held last October, DHCS has released a list of frequently asked questions (FAQs) and answers on various program policies. Below, we've included a handful of questions and answers from the document that LEAs may find particularly interesting, specifically regarding: RMTS for LEA Billing Free Care (Non-IEP) Service Billing ...