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...

RMTS for LEA Billing — Implementation Advisory Group Publishes August Meeting Summary

The Implementation Advisory Group (IAG) provided the following updates from their August 9, 2016 meeting: Workgroup members are testing the draft CRCS and related instructions; two LEA members will be using their own data to provide detailed feedback to DHCS on edits and other suggestions. The draft CRCS is in the final stages of testing and the IAG expects to submit this to CMS in the...

LEA Ad-Hoc Advisory Workgroup Publishes February 2016 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 February 3, 2016 meeting  include: Attendees asked that ongoing DHCS Audits and Investigations (A&I) audits...

Exciting Changes Proposed for California’s LEA Direct Billing Program

In late September 2015, DHCS released a copy of their draft State Plan Amendment (SPA 15-021) which proposes several changes to the LEA Medi-Cal Billing Option program. If approved, the SPA includes several exciting additions that will impact California's participating school districts, including: newly eligible services, practitioners types, and a revised method for capturing time spent...

California Announces Option for LEAs to Resubmit FY 09/10 CRCS Reports

Sacramento, CA - May 15, 2012 - During the California Department of Health Care Services' (DHCS) May 9, 2012 Provider Participation Agreement (PPA) and Annual Report training for schools participating in the LEA Billing Option program, it was announced that LEAs will have the option to resubmit their FY 09/10 CRCS using a state-updated template. This option is an opportunity for those LEAs who had...

California LEAs Waiting for Guidance on Medi-Cal Provider Screening and Enrollment

The Provider Enrollment Division (PED) of the California Department of Health Care Services (DHCS) held stakeholder meetings on March 28 and 29 to discuss changes to screening and enrollment requirements for Medi-Cal providers. The department's Safety Net Financing Division (SNFD) was in attendance, as was Paradigm, to highlight the unique needs of the state's school health providers that are...

Bill to Reauthorize SB 231 (Ortiz, 2001), Moving Through California Legislature

Assembly Member Susan Bonilla (D–Concord) is sponsoring Assembly Bill No. 2608 (AB 2608), a bill that seeks to reauthorize the California statute first established under Senate Bill No. 231 (SB 231). On April 17, 2012, AB 2608 cleared the first hurdle on its way to approval when it was unanimously passed out of the state Assembly Committee on Health. The bill moves next to the Committee on...

PPL 12-006: California Reinvestment of LEA Billing Option Program Reimbursements

PPL 12-006, LEA Medi-Cal Billing Option Program - Changes To Standardized Account Code Structure (SACS) Resource Code 5640, is related to the policy change originally set out in PPL 11-013 regarding the reinvestment of LEA Billing reimbursements in the MAA program. The PPL reiterates that Resource Code 5640 revenues will no longer be considered federal income for the purpose of the LEA Billing...

LEA Billing and the Federal Funding Effect

San Francisco, CA - February 8, 2012 - Paradigm HealthCare Services releases analysis of the effects of using non-matchable federal dollars to fund LEA service providers.   Summary A review of Paradigm clients' 2009-10 CRCS results suggest that on average, although interim rates were overall accurate, LEAs whose provider costs included federal, non-matching, funds were hardest hit by...

California Changes Policy to Allow Claiming of Staff Funded with LEA Billing Reimbursements on MAA Invoice

On July 13, 2011, the California Department of Health Care Services (DHCS) released PPL 11-013, notifying LEAs who participate in both the LEA Direct Billing and School-Based MAA (California's Medicaid Administrative Claiming program) programs that staff funded with LEA Billing reimbursements may now be included on the MAA invoice and CRCS report. This policy change takes effect immediately,...