CMS Has Approved California State Plan Amendment 15-021

On April 28, 2020, CMS released an approval document written to DHCS confirming their approval of State Plan Amendment (SPA) 15-021 with an effective date of July 15, 2020. DHCS has yet to issue a formal announcement to LEAs, however the assumption is that implementation is still on track for July 1, 2020. A copy of the SPA package and approval letter can be found here: CMS Approval…

DHCS Confirms State Plan Amendment (SPA) 15-021 is Officially ‘On the Clock’

On Tuesday, February 11, DHCS sent an email announcing they had formally submitted the State Plan Amendment (SPA)15-021 to Centers for Medicare and Medicaid Services (CMS), who has 90 days to review the package. On Wednesday, February 12, during a DHCS Workgroup meeting, DHCS confirmed that CMS accepted the submission and will adhere to the expected decision date of May 11, 2020. DHCS advised…

DHCS Posts Training Slides and FAQs for Their LEA Medi-Cal Billing Program SPA 15-021 Implementation Training

DHCS held a State Plan Amendment (SPA) 15-021 implementation training in Southern California on April 22, 2019, and in Northern California on May 9, 2019. At the training, they confirmed that SPA 15-021 had not yet been approved by CMS and so all the training was pending that approval. On June 10, 2019, they posted the PowerPoint slides and FAQs. SPA 15-021 Implementation Training Slides…

Highlights from LEA Ad-Hoc Advisory Workgroup June 2019 Meeting

On June 5, 2019, the California Department of Health Care Services (DHCS) held a meeting for the LEA Ad-Hoc Advisory Workgroup, comprised of LEA representatives, DHCS, and the California Department of Education (CDE); the meeting is held to make recommendations and discuss issues impacting the LEA Medi-Cal Billing Option Program. Highlights from the June meeting include: Erroneous Paid…

LEA Ad-Hoc Advisory Workgroup Publishes February 2019 Meeting Minutes

On June 11, 2019, DHCS posted February 6, 2019, meeting minutes for the LEA Ad-Hoc Advisory Workgroup, comprised of LEA representatives, DHCS, and the California Department of Education (CDE); the meeting is held to make recommendations and discuss issues impacting the LEA Medi-Cal Billing Option Program. Highlights from the February meeting included: Effective January 1, 2019, CPT Code…

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…

LEA Medi-Cal Billing Option Program SPA 15-021 General Overview Training—Northern California

The California Department of Health Care Services (DHCS) has announced that in preparation for the approval of the State Plan Amendment (SPA) 15-021 by the Center for Medicare and Medicaid Services (CMS), they will be conducting two General Overview SPA 15-021 trainings for stakeholders that participate in the LEA Billing program. The announcement on April 26, 2019, included information about…

SMAA Workgroup Publishes April 2019 Meeting Notes

The SMAA Workgroup posted the meeting notes from their April 17, 2019, SMAA Workgroup Meeting; highlights from that meeting include: Draft PPL 19-XXX, RMTS Sample Period—Addressing submitted stakeholder comments and questions Moments assigned for the last minute of a shift; currently, the system may create a moment that begins the minute a shift ends (e.g., shifts ending at 5:00 pm may…

LEA Medi-Cal Billing Option Program SPA 15-021 General Overview Training—Southern California

The California Department of Health Care Services (DHCS) has announced that in preparation for the approval of the State Plan Amendment (SPA) 15-021 by the Center for Medicare and Medicaid Services (CMS), they will be conducting two General Overview SPA 15-021 trainings for stakeholders that participate in the LEA Billing program. The announcement today included information about the Southern…

RMTS for LEA Billing—DHCS Hosts Combined Stakeholder Meeting on Oct. 4, 2018

On Thursday, Oct. 4, 2018, the Department of Healthcare Services (DHCS) held the first LEA Billing and School Medi-Cal Administrative Activities (SMAA) combined meeting. Paradigm attended the meeting by webinar and below are the highlights. There are 2 issues DHCS is still working out with CMS before formally submitting the final version of the SPA, which includes RMTS for LEA Billing, for…