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...

DHCS Extends Deadline for First School MAA RMTS Claims

DHCS posted a SMAA Program Update to their website announcing: Extension of the FY 2014-15 Q3 Invoice Submission Deadline -- the deadline for these claims has been extended to July 31, 2016, additional extensions will be considered on a case-by-case basis. The Department is still finalizing the template that will be used to create invoices for FY 2014-15, so this extension is welcome news 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...

Schools Wait for Millions in Reimbursement for Medi-Cal Outreach

It was, without question, a call to action. Millions in federal Medi-Cal funds would flow to California schools, the state auditor said in 2005, if districts filled out the paperwork to collect a little-known reimbursement for the cost of referring low-income students to the health care program. Now, a decade later, California districts and school programs are caught in a fight with the federal...

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...