EPSDT

2016 Legislative Session: Bills We're Tracking

The August deadline is fast approaching for bills in the California legislature to pass out of committee and both…


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…


Senate Bill 276 Recently Passed Addressing Some Billing Issues in Schools

A new law will require the Department of Health Care Services (DHCS) to seek federal dollars for EPSDT-type health…


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…


Many Steps To Go Before Authorizing Autism Therapy As Benefit, State Says

Paradigm Note: For school districts participating in California’s LEA Medi-Cal Billing Option Program (LEA Program)…


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…


Signs Point to Adding Autism Coverage for Kids Under Medi-Cal Managed Care

The state has been considering the addition of autism therapy as a Medi-Cal benefit based on legal developments in…


OIG to Focus on RMTS and School Medicaid Administrative Claiming Programs in 2014 Work Plan

The U.S. Office of Inspector General (OIG) has released their annual Work Plan, a detailed outline of projects for the…


California State Budget Enacted for 2011-12: AB 3632 Mandate Repealed

The California mandate on county mental health (CMH) departments to provide mental health services to eligible special…


Department Appeals Board (DAB) Ruling: Oklahoma Health Care Authority and Free Care

DAB A-03-79, Decision No 1924; the DAB "concludes that the [CMS 1997 Technical Assistance] Guide's free care principle…