Retroactive Guidance for California’s SMAA-RMTS Program May Signal Mass Invoice Revisions

**Update, April 20, 2017: DHCS has verbally stated that this new guidance does not supersede PPL 15-012. DHCS is currently drafting a new PPL to outline the process for handling 100% federally funded or ICR time survey participants that were inadvertently included in an RMTS pool; more details will be available once the new PPL is published.**   On March 30, 2017, DHCS sent an email...

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

The Implementation Advisory Group (IAG) has published minutes from their January 31, 2017 meeting, and discussed the following topics: DHCS presented a draft chart that identified LEA services that are proposed under SPA 15-021. The chart covered IEP/IFSP services, non-IEP services covered under “plans of care” and other non-IEP services that are outside of a plan of care (e.g., first...

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 ...

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

The Implementation Advisory Group (IAG) has published minutes from their December 6, 2016 meeting, and discussed the following topics: The IAG discussed stakeholder feedback from one LEA that was concerned with communication regarding indirect service time being coded to Code 2. The stakeholder was concerned that Code 2 may include moments that are not direct medical services, creating...

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

The Implementation Advisory Group (IAG) has published minutes from their November 8, 2016 meeting, and discussed the following topics: The IAG members reviewed draft LEA Provider Manual language and suggested content placement related to incorporating RMTS information into the existing LEA Provider Manual. The IAG members will review an updated version of the proposed LEA Provider Manual...

CMS Approves California’s SMAA Program Manual

On Thursday, November 10, DHCS released the final CMS approved manual and invoice template for the School-Based Medi-Cal Administrative Activities (SMAA) program. The new manual is effective back to January 2015, covering the first quarters that California LEAs began using the Random Moment Time Survey (RMTS) method for the SMAA program. The first RMTS claims, for fiscal year 2014-15 Q3, are...

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

The Implementation Advisory Group (IAG) has published minutes from their October 4, 2016 meeting, and discussed several important topics: The IAG reviewed proposed procedure codes and modifiers for the new services and practitioners included in SPA 15-021. The IAG members discussed how RMTS will be incorporated into the LEA Provider Manual The next IAG meeting is scheduled for November...

OIG Publishes New State Audits of School-Based Medicaid Programs

The federal Office of Inspector General (OIG) has published new audit reports of school-based administrative and health services programs in North Carolina and Michigan. Random Moment Time Sampling (RMTS) continues to be a focus of OIG school-based program audits but the impact of these findings vary from state to state, as they do in the two reports released earlier this month. Concerns have...

DHCS Launches New Webpage for SMAA Workgroup Meeting Summaries

On Monday, DHCS SMAA Chief, Tony Teresi, announced that DHCS had created a new page on their website to house meeting information related to the bi-weekly SMAA Workgroup. You can visit the page here, and view meeting summaries for the past three meetings.

Governor Vetoes Senate Bill 123, SMAA Program Improvements

Governor Jerry Brown has vetoed Senate Bill 123, a bill authored by Senator Carol Liu to legislate recommendations by the State Auditor aimed at improving California's school-based Medi-Cal Administrative Activities (SMAA) program. Senator Liu's office has expressed disappointment but also noted that the hard work to improve California's SMAA program, and the students and families who benefit...