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...

LEA Ad-Hoc Advisory Workgroup Publishes June 2017 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 June 7, 2017 meeting include: In April 2017, DHCS posted the finalized Annual Accounting of Funds Summary Report...

CMS Announces Medicaid and School-Based Health Services Affinity Group

The federal Centers for Medicare & Medicaid Services (CMS) has announced the development of a new group for state Medicaid agencies interested in "partnering with schools and public health to improve access to and the delivery of important preventative health services for children and adolescents." Officially called the Medicaid and School-Based Health Services Delivery Affinity Group, this...

Senate Rejects Slimmed-Down Obamacare Repeal as McCain Votes No

"WASHINGTON — The Senate in the early hours of Friday morning rejected a new, scaled-down Republican plan to repeal parts of the Affordable Care Act, derailing the Republicans’ seven-year campaign to dismantle President Barack Obama’s signature health care law and dealing a huge political setback to President Trump. Senator John McCain of Arizona, who just this week returned to the Senate...

OT/PT Service Billing Impacted by Change to California Children’s Services Program

California's 2017-18 state budget, which went into effect on July 1, 2017, included $1.6 million for nonmedically necessary OT and PT services to the California Children's Services (CCS) Medical Therapy program. While CCS was previously required to provide OT and PT services that the agency determined were medically necessary for CCS-eligible children, these sometimes only included a fraction...

To Protect Children, Senate Republicans Must Drop Medicaid Per Capita Cap

"The Senate Republican health bill, like the House-passed bill, would convert Medicaid to a per capita cap, but it would cut Medicaid even more deeply and pose an even greater threat to coverage for all Medicaid beneficiaries — including children..." Read the full article: CBPP, June 23, 2017, To Protect Children, Senate Republicans Must Drop Medicaid Per Capita Cap | Center on Budget and...

The Medicaid Cap: “Carving Out” Medically Complex Kids Won’t Protect Them

"The Senate Leadership is reportedly including a cap on federal Medicaid payments to states in its version of legislation to “repeal and replace” the ACA.  That cap will apparently look a lot like the cap that narrowly passed the House in early May, but with some tweaks to accommodate concerns of individual Senators. One tweak under consideration has to do with “carving out” medically...

Schools Brace for Impact if Congress Cuts Medicaid Spending

"For school districts still getting their financial footing after the Great Recession, the Medicaid changes being advanced as part of the health care overhaul are sounding familiar alarms. Administrators say programming and services even beyond those that receive funding from the state-federal health care program could be at risk should Congress follow through with plans to change the way...

A Little-Noticed Target in the House Health Bill: Special Education

"WASHINGTON — While House Republicans lined up votes Wednesday for a Thursday showdown over their bill to repeal the Affordable Care Act, Vickie Glenn sat in her Murphysboro, Ill., office and prayed for it to fail. Ms. Glenn, a Medicaid coordinator for Tri-County Special Education, an Illinois cooperative that helps more than 20 school districts deliver special education services to students,...