Update: California School MAA Deferral Process Appears Stalled, March 6, 2013

Following the implementation of a process to certify and remove pending school MAA claims from ongoing federal deferral, an estimated 700 California school districts and claiming units continue to wait for processing, approval, and subsequent payment of millions in unrestricted federal reimbursement.

The process to certify and remove school districts from federal deferral was established last August by the California Department of Health Care Services (DHCS) and the federal Centers for Medicare and Medicaid Services (CMS) following the notification in June that payment for unpaid school Medi-Cal Administrative Activities (MAA) claims would be deferred pending additional documentation.

Throughout the fall of 2012, roughly 50 deferral certifications were reviewed and approved by CMS for payment; though no certifications appear to have been processed since December. By previous DHCS estimates, this leaves roughly 700 school districts and claiming units waiting for information regarding the status of their deferral certification.

The release of payment for pending claims, some reaching back to the last quarter of fiscal year 2009-10, is particularly urgent as schools throughout California finalize budgets for the upcoming year and prepare to issue pink slips by the rapidly approaching deadline of May 15. Since there are no restrictions on how MAA reimbursements may be spent, these often fund a range of essential services and needs including personnel, equipment, health and other educational costs.

In addition to losing these critical reimbursements, without them schools would likely be forced to cut spending on administrative work that is critical to supporting student and family access to health services and coverage at a time when the state is intently focused on reaching the uninsured and those that will be newly eligible under federal health reform in 2014.


About the School MAA Deferral

Medicaid regulations allow districts to be reimbursed for a portion of the costs incurred helping students and families access health services and Medicaid (Medi-Cal). Known as the school Medi-Cal Administrative Activities (MAA) program in California,school districts have utilized this program to recoup millions of dollars in federal reimbursement for eligible activities performed in administration of the Medi-Cal program since 1998.

In June of 2012 the federal Centers for Medicare & Medicaid Services (CMS) notified the state of California that it was deferring payment on unpaid school MAA claims and that the state must change the claiming methodology used for the program. Participating schools districts were given the opportunity to certify their pending claims via a deferral certification form released by DHCS (who collaborated with CMS to create the form) in August of 2012.


Stay Informed

As information on the deferral becomes publicly available, we will continue to post updates to the Policy Center. All archived news, events, publications and reference materials related to the deferral can be found on our Issue Analysis page devoted to this topic. Paradigm clients should refer to regular email communications and bulletins for operational guidance and additional details on this evolving situation.


Read More

Read the CMS Notice to California regarding the school MAA claims deferral…

Read our complete issue analysis of California’s school MAA program deferral, including all related news posts, publications, and source documents…