RMTS for LEA Billing – Implementation Advisory Group Publishes April Meeting Summary

The Implementation Advisory Group (IAG) provided the following updates from their April 5, 2016, meeting: DHCS discussed stakeholder feedback regarding an inquiry as to whether RMTS coders would need to determine whether direct health service moments coded to Code 2 were actually billed with proper supporting documentation by a qualified Medi-Cal provider. Belief is that the coder will be...

Senate Bill 276 Passes, Taking One Step Closer to Rollout of Free Care

September 2, 2015 – Sacramento, CA – The California Senate recently passed Senate Bill (SB) 276, introduced by Senator Wolk; this is exciting news because this directly impacts both the free care and Third Party Liability (TPL) billing issues for California schools. You may recall, in December 2014 the Centers for Medicare & Medicaid Services (CMS) reversed their opinion on “free...

Senate Bill 276 Recently Passed Addressing Some Billing Issues in Schools

A new law will require the Department of Health Care Services (DHCS) to seek federal dollars for EPSDT-type health services provided by schools to their general education population. SB 276 also seeks to address the barrier to reimbursement for students with both Medi-Cal and other health coverage known as Third Party Liability (TPL). Senate Bill (SB) 276, which Paradigm has been tracking, was...

State Auditor Releases Report of the Audit of the California Department of Health Care Services

On August 20, 2015 the California State Auditor released their report entitled “California Department of Health Care Services: It Should Improve Its Administration and Oversight of School-Based Medi-Cal Programs.” This report is the result of the state audit approved in August of last year (2014) by the Joint Legislative Audit Committee related to their administration of both the school MAA...

Paradigm is Proud to Announce New Student Health Network (SHN)

May 8, 2015 – San Francisco, CA – Paradigm is excited to announce that this Fall we will be launching our new Student Health Network (SHN) though we currently have some early-adopters who are already using the new SHN in what we have termed the “SHN Beta” period. These early adopters will be using the new SHN and providing feedback so that we can continue to make this a product that works...

You Inspire Us!

December 16, 2014 – San Francisco, CA – We at Paradigm believe that School Medicaid Billing Programs play a significant role in enhancing opportunities for students and families in our communities. Moreover, we know this would not be possible without the commitment, and dedication, to gathering the paper, signing the forms, and organizing the files—your daily work makes a difference for...

OIG Releases Work Plan for 2015, Cites Concern with RMTS Cost Allocation for 2nd Year in a Row

For the second year in a row, a major federal auditing body of school-based MAA programs throughout the country has listed the review of random moment time survey (RMTS) systems as a priority. In their 2015 Work Plan, the Office of Inspector General (OIG) states, “Prior OIG reviews of school-based and community-based administrative claims found significant unallowable payments when payments were...

Children Now Releases the 2014 California County Scorecard

Children Now is an advocacy organization in California whose mission is to promote children's health and education in the state and creating national media polices that support child development.  They have released the 2014-15 County Scorecard of Children's Well-Being.  This tool tracks 29 key Education, Health, and Child Welfare and Economic Well-Being indicators in California, across 58...

2014-15 California County Scorecard by Children Now

The 2014-15 California County Scorecard of Children's Well-Being tracks 29 key Education, Health, and Child Welfare and Economic Well-Being indicators in California, across 58 counties, over time, and by race and ethnicity. By providing a robust snapshot of children’s well-being, the Scorecard encourages the discovery of best practices, fosters collaboration, and supports action by...

California’s New School MAA Program Likely Delayed Until January 1, 2015

California's Department of Health Care Services (DHCS) has reportedly received approval from the federal government to delay implementation of California's new school MAA program until the third quarter of the 2014/15 fiscal year. Although the state has yet to publish this announcement on their website, they have communicated the information to regional LECs and LGAs that, in turn, have begun to...