Roundup of Recently Published PPLs for California’s LEA Billing Program

California Department of Health Care Services (DHCS) has sent out another round of LEA Billing Policy and Procedure Letters (PPLs) as it continues to solidify implementation of State Plan Amendment 15-021. Paradigm’s roundup is below, including key takeaways. PPL 20-038, August 11 – Increase in Federal Medicaid Assistance Percentage (FMAP) In response to and during the national emergency,…

PPL 20-031: Random Moment Time Survey (RMTS) Participant Equivalency Process

On Friday, July 31, 2020, California DHCS released PPL No. 20-031 outlining the process and requirements for its RMTS Time Survey Participant (TSP) List Equivalency Request for LEA Billing purposes. This is good news for LEAs with providers who perform direct medical services as a primary job function but do not have a job title that matches the approved RMTS classification list. DHCS is…

PPL 20-023: Submitting Quarterly Random Moment Time Survey (RMTS) Percentage Results to the Department of Health Care Services (DHCS)

On Tuesday, July 7, 2020, DHCS published Policy & Procedure Letter 20-023, titled “Submitting Quarterly Random Time Moment Survey (RMTS) Percentage Results to the Department of Health Care Services (DHCS)”. This PPL supersedes PPL 19-004R which was released in June, 2019 (click here for more on PPL 19-004R). The purpose of PPL 20-023 is to provide instructions on the submission of final…

PPL 20-022: Notification of Random Moment Time Survey Requirement for the Local Educational Agency Medi-Cal Billing Option program

On Thursday, June 25, 2020, DHCS published Policy & Procedure Letter 20-022, titled "Notification of Random Moment Time Survey Requirement (RMTS) for the Local Educational Agency Medi-Cal Billing Option Program.” The information shared in this PPL 20-022 is specific to the changes that will take place due to the RMTS integration with the CRCS, most of which has been anticipated for quite some…

PPL 20-014: CA Telehealth Policy Relative to the 2019 – Novel Coronavirus (COVID-19)

On Monday, May 11, 2020, DHCS released PPL 20-014, titled “Telehealth Policy Relative to the 2019 -Novel Coronavirus (COVID-19). The PPL specifies that during this national emergency, all LEA providers may bill for covered direct medical services provided via telehealth under the LEA Billing program, with exception of services that preclude a telehealth modality, such as specialized medical…

DHCS News Roundup

Over the past week, DHCS sent a handful of email announcements to LEAs regarding the operations of LEA Billing.  For your information, the roundup is below:  2017/18 CRCS Submission Docs Update   On Sept. 27, 2019, DHCS posted the template documents for the 2017/18 CRCS. In addition, DHCS posted PPL 19-019 (Sept 18, 2019), which calls for a small change in how to submit your CRCS to DHCS.…

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 rather than…

PPL 19-011R—Random Moment Time Survey (RMTS) Sampling Requirements—Now Available on DHCS Website

On June 13, 2019, DHCS published Policy and Procedure Letter (PPL) 19-011R Random Moment Time Survey (RMTS) Sampling Requirements to their website. This PPL confirms that, since a moment in RMTS is one minute in time, there should not be any moments issued during the final minute of a time survey participant’s (TSP) work schedule. DHCS gives the example that if a TSP is scheduled to work an…

Revision to PPL 19-004 Posted to DHCS Website

On June 5, 2019, DHCS posted a revision to their Policy and Procedure Letter (PPL) 19-004 Submitting Quarterly Random Moment Time Survey (RMTS) Percentage Results to the Department of Healthcare Services (DHCS)—originally posted on January 11, 2019—to the SMAA website. Below are the updated links: PPL 19-004R PPL 19-004R Attachment A The revision includes updated due dates to…

SMAA Workgroup Publishes May 2019 Meeting Notes

The SMAA Workgroup posted the meeting notes from their May 1, 2019, SMAA Workgroup Meeting; highlights from that meeting include: Draft PPL 19-XXX, RMTS Sample Period—Continued the discussion from their April 17 meeting specifically regarding adjusting quarter four to accommodate the four day response period, see below: DHCS confirmed that reducing the quarter 4 sample period by 4 student…