July Medi-Cal Bulletin for LEAs Posted

The July 2019 Medi-Cal Bulletin for LEAs has been published to the DHCS website. It included an adjustment to the reimbursement rates for LEA Services for FY 2019/20. Click here to read the current or past Bulletins.

DHCS Posts PPL 19-015, Notification of Change to Physician Prescription Policy

On July 10, 2019, DHCS posted Policy and Procedure Letter (PPL) 19-015 stating that for services dated July 1, 2019, and forward, treatment authorizations (orders/prescriptions) signed by Physician Assistants (“PA”) or Nurse Practitioners (“NP”) are eligible. This means, for example, that the specialized procedure orders that in the past met the criteria but were signed by a PA or NP...

June Medi-Cal Bulletin for LEAs Posted

The June 2019 Medi-Cal Bulletin for LEAs has been published to the DHCS website. There was no LEA Billing program-specific information of note in this month's Bulletin. Click here to read the current or past Bulletins.

DHCS Posts Training Slides and FAQs for Their LEA Medi-Cal Billing Program SPA 15-021 Implementation Training

DHCS held a State Plan Amendment (SPA) 15-021 implementation training in Southern California on April 22, 2019, and in Northern California on May 9, 2019. At the training, they confirmed that SPA 15-021 had not yet been approved by CMS and so all the training was pending that approval. On June 10, 2019, they posted the PowerPoint slides and FAQs. SPA 15-021 Implementation Training Slides ...

Highlights from LEA Ad-Hoc Advisory Workgroup June 2019 Meeting

On June 5, 2019, the California Department of Health Care Services (DHCS) held a meeting for the LEA Ad-Hoc Advisory Workgroup, comprised of LEA representatives, DHCS, and the California Department of Education (CDE); the meeting is held to make recommendations and discuss issues impacting the LEA Medi-Cal Billing Option Program. Highlights from the June meeting include: Erroneous Paid...

LEA Ad-Hoc Advisory Workgroup Publishes February 2019 Meeting Minutes

On June 11, 2019, DHCS posted February 6, 2019, meeting minutes for the LEA Ad-Hoc Advisory Workgroup, comprised of LEA representatives, DHCS, and the California Department of Education (CDE); the meeting is held to make recommendations and discuss issues impacting the LEA Medi-Cal Billing Option Program. Highlights from the February meeting included: Effective January 1, 2019, CPT Code...

DHCS Wants to Hear from Current Participants of the LEA Billing Program—Requests Information Via Survey

On June 5, 2019, DHCS sent an email to their LEA Billing mailing list reaching out to its stakeholders in order to account for LEAs that currently participate in the LEA Program, but do not participate in the School-Based Medi-Cal Administrative Activities (SMAA) Program. The stated goal of the survey is to provide technical assistance to LEA providers that may not be familiar with the Random...

May Medi-Cal Bulletin for LEAs Posted—DHCS Transitioning Fiscal Intermediary Services

The May 2019 Medi-Cal Bulletin for LEAs has been published to the DHCS website. One item of interest in this month's Bulletin is that DHCS will be transitioning fiscal intermediary services from the current Conduent to DXC Technologies Services, LLC. This transition is projected to occur on October 1, 2019, and DHCS has said that payments should continue as normal as ensuring payments to...

DHCS’ Provider Enrollment Division (PED) Updates Ordering, Referring, and Prescribing (ORP) Provider Enrollment Rules

DHCS has confirmed that their Provider Enrollment Division (PED) has updated enrollment rules to ensure applications from registered, credentialed school nurses (RCSNs) and licensed educational psychologists (LEPs) will no longer be denied. Effectively immediately, LEP and RCSN providers may re-submit applications to enroll as Medi-Cal ORP providers in order to comply with the LEA Program’s...

LEA Medi-Cal Billing Option Program SPA 15-021 General Overview Training—Northern California

The California Department of Health Care Services (DHCS) has announced that in preparation for the approval of the State Plan Amendment (SPA) 15-021 by the Center for Medicare and Medicaid Services (CMS), they will be conducting two General Overview SPA 15-021 trainings for stakeholders that participate in the LEA Billing program. The announcement on April 26, 2019, included information about...