January 17, 2017
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...
December 2, 2016
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...
November 16, 2016
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...
November 3, 2016
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...
October 31, 2016
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...
October 11, 2016
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.
September 29, 2016
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...
September 21, 2016
RMTS for LEA Billing — Implementation Advisory Group Publishes September Meeting Summary
The Implementation Advisory Group (IAG) has published minutes from their September 13, 2016 meeting, which included a review of the draft State Plan Amendment and RMTS-related training slides for the Fall LEA Program training, scheduled for October 13, 2016.
If you are not yet registered for the upcoming DHCS Fall LEA Program training, which will be hosted via web conferencing, click here...
August 30, 2016
Free Care Manual Update & Service Rates Expected September 2016
In an email dated August 30, 2016, California's Department of Health Care Services (DHCS) announced several updates to ongoing policy and guidance related to the LEA Medi-Cal Billing Option Program.
Key updates regarding DHCS' Free Care Policy Clarification and rates for Telehealth and new Speech codes are not yet effective. DHCS states that they anticipate these will be published in September...
August 22, 2016
RMTS for LEA Billing — Implementation Advisory Group Publishes August Meeting Summary
The Implementation Advisory Group (IAG) provided the following updates from their August 9, 2016 meeting:
Workgroup members are testing the draft CRCS and related instructions; two LEA members will be using their own data to provide detailed feedback to DHCS on edits and other suggestions. The draft CRCS is in the final stages of testing and the IAG expects to submit this to CMS in the...