SMAA Workgroup Publishes May 2019 Meeting Notes

The SMAA Workgroup posted the meeting notes from their May 1, 2019, SMAA Workgroup Meeting; highlights from that meeting include: Draft PPL 19-XXX, RMTS Sample Period—Continued the discussion from their April 17 meeting specifically regarding adjusting quarter four to accommodate the four day response period, see below: DHCS confirmed that reducing the quarter 4 sample period by 4...

SMAA Workgroup Publishes April 2019 Meeting Notes

The SMAA Workgroup posted the meeting notes from their April 17, 2019, SMAA Workgroup Meeting; highlights from that meeting include: Draft PPL 19-XXX, RMTS Sample Period—Addressing submitted stakeholder comments and questions Moments assigned for the last minute of a shift; currently, the system may create a moment that begins the minute a shift ends (e.g., shifts ending at 5:00 pm may...

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...

Huge Win for School Medicaid Programs as CMS Changes Restrictive Free Care Policy

The federal Centers for Medicare and Medicare Services (CMS) has issued a letter to all State Medicaid Directors withdrawing their prior guidance on the free care policy, Medicaid Payment for Services Provided without Charge (Free Care). This is welcome and exciting news for school districts that participate in their state's school-based Medicaid billing program, many of whom have been waiting...

California Receives Federal Approval for New School MAA Program Plan

Following two years of negotiation with federal Centers for Medicare and Medicaid Services (CMS), California's Department of Health Care Services (DHCS) received conditional approval for a new school MAA (SMAA) program plan. While there are a few cosmetic changes that will need to be made to the June 2014 draft plan, schools are expected to begin claiming Medi-Cal outreach and enrollment...

CMS Releases Series of EPSDT Briefs, Addresses Medical Necessity Issues

Last week CMS published three new guides focused on Medicaid's Early and Periodic Screening, Diagnosis and Treatment (EPSDT) benefit. Over the past many years states as well as providers, patients and their families have raised questions about various aspects of EPSDT. The guides are intended to assist states in complying with CMS' interpretation of the EPSDT statute and regulations. The...

Medicaid & CHIP: October Monthly Applications and Eligibility Determinations Report

This report is the first in a series of monthly reports on State Medicaid and Children’s Health Insurance Program (CHIP) data, and represents State Medicaid and CHIP agency eligibility activity for the calendar month of October 2013, which coincides with the first month of the initial open enrollment period for the Health Insurance Marketplace. Read the full CMS report here...   ...

Deferral Resolution and New Plan Milestone Timeline Approval Letter

Effective October 23, 2013, the Centers for Medicare and Medicaid Services (CMS) has granted approval to the California  Department of Health Care Services (DHCS) for the methodology developed to resolve all deferred costs for school based administrative claims and a request to permit interim claiming for school based administrative costs incurred during State Fiscal Year (SFY) 2013/2014. The...

CMS Gives Informal Approval for Interim School MAA Claiming in California

California's Department of Health Care Services (DHCS) posted another school MAA (SMAA) program update to their website on September 17, 2013. The update confirms that DHCS has received informal approval from the Centers for Medicare and Medicaid Services (CMS) on several key issues related to the ongoing SMAA program deferral and development of a new claiming plan: SMAA Time Survey for FY...