PPL 13-012: Reasonableness Test Criteria (RTC) – Updated

**Note: DHCS released a revised and updated version of PPL 13-012 on December 13, 2013. This revision makes important clarifications to the RTC process. The purpose of this Policy and Procedure Letter (PPL) is to establish the parameters for LEAs, LECs and LGAs to apply the Reasonableness Test Criteria (RTC) developed by the Department of Health Care Services (DHCS) in accordance with the…

PPL 13-015: Interim Claiming Plan Procedure Changes for LEAs for SFY 2013-14

The Centers for Medicare and Medicaid Services (CMS) approved an Interim Claiming process for the SMAA program on November 1, 2013. Each LEA must identify their Time Survey Participant Universe prior to any LEA participation in the Interim Claiming process for SFY 2013-2014. Download PPL 13-015 - Interim Claiming Procedure Change... View Attachment A, 'Time Survey Authorized Positions and…

PPL 13-013: CMAA/TCM Implementation Plan Amendment – MAA for Inmates

The purpose of this Policy & Procedure Letter is to notify LGA’s participating in the CMAA Program of an amendment to the "Time Survey Methodology for the County Based Medi-Cal Administrative Activities (CMAA) and Targeted Case Management (TCM) Programs and CMAA Program Operational Plan". Per PPL 13-013 and the CMS approval letter which authorized it, effective immediately, CMAA program…

Draft California School-Based MAA and RMTS Manual, October 2013

The first draft of California's new school Medi-Cal Administrative Activities (SMAA) plan, which will utilize the Random Moment Time Survey (RMTS) methodology, was posted to the Department of Health Care Services' (DHCS) website on October 25, 2013. DHCS will continue negotiating details of the new school SMAA program with federal CMS and is anticipated to release the final plan with an…

PPL 13-001: LEA Billing Program – Revision to Medical Transportation Outlined in Assembly Bill 2608

This Policy and Procedure Letter (PPL) notifies LEAs participating in the LEA Medi-Cal Billing Option Program that specific provisions set forth in the California Code of Regulations (CCR), Title 22 Sections 51323(a)(2)(A), 51323(a)(3)(B), 51231.1(f), and 51231.2(e), shall not apply to medical transportation eligible to be billed under the LEA Medi-Cal Billing Option Program. Read PPL 13-001-LEA…

Example CMS Deferral Release Notification Letter

This example correspondence from the Department of Health Care Services (DHCS) to a California regional agency announces the release from CMS deferral of a contracted school district participating in the school MAA program. DHCS Deferral Approval Letter_Redacted.pdf