DHCS Publishes New LEA Billing FAQs

As a follow-up from the Fall 2016 LEA Billing DHCS training held last October, DHCS has released a list of frequently asked questions (FAQs) and answers on various program policies. Below, we've included a handful of questions and answers from the document that LEAs may find particularly interesting, specifically regarding: RMTS for LEA Billing Free Care (Non-IEP) Service Billing ...

California Quietly Rolls Out School Medicaid Billing for Non-IEP/IFSP Students

Following the December 2014 repeal of the federal Free Care rule, this week the Department of Health Care Services (DHCS) published an updated Provider Manual for the LEA Medi-Cal Billing Option program which removes references to the prohibitive Free Care rule. This update technically clears the way for public schools in California to begin billing for certain health services, including...

LEA Ad-Hoc Advisory Workgroup Publishes June 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 1, 2016 meeting include: Review of Senate Bill 123, which would have a limited impact on the LEA Medi-Cal...

DHCS Issues Policy on Third Party Liability Recoupment

California’s Department of Health Care Services (DHCS) has released PPL 16-012, ‘Notification of Third Party Liability (TPL) Recoupment Requirements’, to LEAs participating in the LEA Medi-Cal Billing Option program. This policy serves to clarify the requirements of pursing TPL and outlines DHCS’ process for ensuring these requirements are met. Paradigm will be working with its clients...

HHS and DOE Release Joint Letter on the Link Between Health and Education Services

A joint letter was released by the Secretary of Health and Human Services and the Acting Secretary of Education which praises and encourages a continued partnership between health and education services for children. Acknowledging the role that health plays in education, the Secretary of Health and Human Services and the Acting Secretary of Education released a letter today that encourages...

California Supreme Court Rules in School Insulin Case

SACRAMENTO, Calif. -- Trained school employees can administer insulin shots to diabetic students if a nurse is not available, the California Supreme Court unanimously ruled on Monday. The ruling reverses a lower court decision that said California law allows only licensed professionals to administer the shots. The Supreme Court ruled that "state law in effect leaves to each student's...

New Resources for California LEAs Implementing IDEA Parental Consent Requirements

Earlier this year the federal government made changes to parental consent requirements for school districts seeking access to Medicaid (Medi-Cal in California) reimbursement for medically necessary health services provided to students under the Individuals with Disabilities Education Act (IDEA). The new requirements primarily concern changes to frequency and formatting of parental consent, and are...

Welcomed, Positive Resolutions After Years of Advocacy

It is said that slow and steady wins the race. This adage proved true for longstanding efforts aimed at resolving two issues that had limited the overall Medicaid reimbursement potential for schools in California. March 25, 2013 – San Francisco, CA – The turn of the New Year has been nothing short of encouraging for those who dedicate their time, resources, and careers to school Medicaid...

CDE Releases Guidelines for Compliance with Revised IDEA Parental Consent Requirements

On March 13, 2013, California's Department of Education (CDE) released a letter to assist local educational agencies (LEAs) in understanding requirements related to the use of public benefits and insurance to support the costs of providing IEP and IFSP services to students with disabilities under the Individuals with Disabilities Education Act (IDEA). The letter, which outlines state-specific...

U.S. Department of Education Publishes New Regulations Easing Burden of Parental Consent Requirements for Schools

On Thursday, February 14, 2013, the U.S. Department of Education (DOE) published final regulations that amend parental consent requirements under Part B of the Individuals with Disabilities Education Act (IDEA). This change signals greater access to Medicaid reimbursements for eligible special education health services provided by schools across the nation. Effective March 18, 2013, the new...