Register by November 22 for Next LEA Advisory Workgroup Meeting

LEAs interested in attending the bi-monthly LEA Advisory Workgroup meeting (also known as the 'LEA Ad-Hoc Meeting') should RSVP to Cheryl Ward at DHCS by Wednesday, November 22, 2017. The meeting will take place on December 13, 2017 from 10:30 a.m. - 3:30 p.m. at Natomas Unified School District in the Staff Development Room, 1931 Arena Boulevard, in Sacramento. Previous meeting notes and...

SDUSD Makes the Case for School Health Services

Michelle Bell, a longtime member of our school Medicaid billing community, was recently featured in an article about the impact of school health services on the students in San Diego Unified School District. We're proud to work alongside Michelle and grateful for the attention she brings to the importance of school health services and programs on a daily basis. The article was published by...

New Resource for LEAs & Parents Regarding EOBs for School Health Services

DHCS has published a one-page informational that LEAs can share with parents regarding private insurance, explanation of benefits (EOB) statement for school health services, and impact to public benefits. When a child has both Medi-Cal and Other Health Coverage (OHC) through private insurance, and a school is billing Medi-Cal for eligible health services provided to that student under the LEA...

UPDATED: DHCS Clarifies Position, Expressly Allows OT & PT Treatment Services Prescribed by LEA-Contracted Physicians

**Update as of October 2, 2017** Since this post was originally published, DHCS has extended the 6-month renewal requirement to an annual renewal requirement for OT and PT prescriptions. The announcement was made in an email from DHCS to LEAs on September 27, 2017, stating: "On August 24, 2017, DHCS sent the above policy update, with an additional requirement that prescriptions for PT/OT...

2017 California Legislation: What Passed & What Didn’t

In September, several bills with possible implications for school health programs under consideration by the California Legislature were either suspended or passed and signed into law by the Governor.  Two bills with direct implications for the SMAA and LEA Billing programs, AB 834 and AB 481, both failed to pass out of committee. Read on for a brief summary of what passed, what didn't, and...

September Medi-Cal Bulletin for LEAs Posted – Updated Reimbursement Rates & Adjustments of LEA Claims

The September Medi-Cal Bulletin for California LEAs has been published to the DHCS website. Two items of interest include: Notification that LEAs can expect to see additional dollars related to retroactive reimbursement rate increases dating back to dates of survey on or after July 1, 2016. DHCS has published the adjusted rates here on their website: FY 2016-17 Current Reimbursement Rates...

Help the California School-Based Health Alliance Set Their 2018 Policy Priorities

The California School-Based Health Alliance (CSHA), a statewide nonprofit which aims to improve health and academic success of children and youth by advancing health services in schools, is setting their policy priorities for 2018 and inviting CSHA members to provide feedback during a call on September 20, 2017. Over the past several years, CSHA has worked to advance several issues impacting...

DHCS Issues Clarification on Coordination of Care with Managed Care Plans

California's Department of Health Care Services (DHCS) has issued clarification on a previous email regarding protocols for LEAs coordinating care with Managed Care Plans (MCPs). The original email, sent on August 9, had raised questions about what appeared to be new coordination requirements. In a clarification email sent on August 18, DHCS underscored that there is no new policy and their...

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

The Implementation Advisory Group (IAG) has published minutes from their August 1, 2017 meeting. Of interest: DHCS gave a brief update on SPA 15-021,  noting that on June 9th CMS asked several additional Requests for Information (RAIs). The Department noted that the RAI responses are undergoing final management review before they will be submitted to CMS. In addition, the LEA RMTS...

California Announces New System for Obtaining Student Medi-Cal Eligibility Information

DHCS has notified California LEAs and their billing partners that a new system, known as MOVEit, will be used moving forward for transmitting all Medi-Cal eligibility information (i.e. the data tape match) for the LEA Billing Option program. The MOVEit system was launched last year and is currently utilized by select LECs and LGAs for the SMAA program. All LEAs and billing vendors are required...