Update on Attachment 1B of the Annual Report/PPA Package for California LEAs

San Francisco, CA – December 28, 2011 – Paradigm has received clarification from California Department of Health Care Services (DHCS) regarding Attachment 1B, “Certification of State Matching Funds for Retroactive Claiming”, of the annual report/provider participation agreement (PPA) package for LEAs participating in the LEA Billing program.

Most California LEAs have submitted their annual report/PPA package, which was due November 30, 2011, to the state for approval as a requirement of continued participation in the LEA Billing Option Program.

This year, the process was somewhat new in that the PPA is now an annual requirement in combination with the annual report.  There were also some new attachments that had not been included in previous versions of either the annual report or PPA.

Although Paradigm is not responsible for LEA clients’ completion of the annual report/PPA package, we have been a sounding board for their inquiries regarding this process.  This year, there was particular confusion over specifications related to the new Attachment 1B; “Certification of State Matching Funds for Retroactive Claiming”, including whether or not it was actually required.

Recently, we received clarification regarding Attachment 1B from DHCS, confirming:

  1. Attachment 1B, “Certification of State Matching Funds for Retroactive Claiming” is required to be submitted if the LEA received any reimbursements during FY 2010-2011.
  2. The dollar amount identified on Attachment 1B should reflect the amount entered as available for “State Match” on the FY 2010-2011 annual report.
  3. Those LEAs that received reimbursements during FY 2010-2011 and did not include Attachment 1B in their annual report/PPA submission this year, should complete Attachment 1B (attached), obtain the appropriate signature, and mail it directly to:

Angelia Johnson

Department of Health Care Services

Safety Net Financing Division

LEA Medi-Cal Billing Option

1501 Capitol Avenue, MS 4603, P.O. Box 997436

Sacramento, CA 95899-7436


If you should have any additional questions, please contact Paradigm Support so that we can assist you in finding the answers.