DHCS Rolls Out New Authorization Requirements for the LEA Billing Program

On June 1, 2018, DHCS released their long-awaited new policy which will require all practitioners who order, refer, or prescribe (ORP) treatment services billed under the LEA Billing program to obtain a National Provider Identification (NPI) number and be separately enrolled in Medi-Cal. Effective for all dates of service on July 1, 2018 and later, PPL 18-018 includes additional details about...

National Research Project Needs Your Input

The American Federation of Teachers (AFT) is conducting research into school Medicaid programs across the country in an effort to collect data on how schools and districts leverage Medicaid billing for student health. If you are a program coordinator and would like to participate, or just learn more about the research project, follow the link below. The study takes just shy of 30 minutes to...

LEA Ad-Hoc Advisory Workgroup Publishes February 2018 Meeting Minutes

The LEA Ad-Hoc Advisory Workgroup, comprised of LEA representatives, DHCS, and the California Department of Education (CDE), held their regularly scheduled meeting to make recommendations and discuss issues impacting the LEA Medi-Cal Billing Option Program. Highlights from the February 7, 2018 meeting minutes include: A confirmation that when RMTS rolls into the LEA Billing program, Code...

Healthy Schools Campaign Hosting Webinar on Free Care

**This post has been updated to include a link to the webinar recording** Date: Wednesday, February 28, 2018 Time: 11am-12pm PST Register: Closed   About the event: The change in the free care policy presents an important opportunity to increase access to and resources for school health services. While the December 2014 State Medicaid Director letter clarified that school...

Federal Government Set to Reopen with Temporary Funding Bill through Feb. 8

This morning, the U.S. Senate passed a temporary funding bill to pave the way for keeping the federal government open through February 8, 2018. The bill still needs to pass the U.S. House, and is expected to do so easily. A permanent funding bill would need to be passed prior to February 8 to avoid another shutdown. As previously reported, we do not anticipate any impact to school-Medicaid...

Will a government shutdown impact school-Medicaid payments?

As the deadline looms for the federal government to approve funding for the fiscal year and avoid a shutdown, school-Medicaid stakeholders may be wondering what impact a shutdown would have on their programs. It doesn't appear that Medicaid payments will be affected by a temporary shutdown.  Several Federal congressional legislators have already identified on their websites that Medicare,...

RMTS for LEA Billing—Implementation Advisory Group Publishes October Meeting Summary

The Implementation Advisory Group (IAG) has published minutes from their October 3, 2017 meeting. Of interest: Navigant presented the technical RMTS “Wish List” items that were discussed during previous IAG meetings. The IAG discussed these items with DHCS and asked for them to be considered in the upcoming RMTS software system Request for Proposal (RFP). The LECs in attendance stated...

LEA Ad-Hoc Advisory Workgroup Publishes August 2017 Meeting Minutes

The LEA Ad-Hoc Advisory Workgroup, comprised of LEA representatives, DHCS, and the California Department of Education (CDE), held their regularly scheduled meeting to make recommendations and discuss issues impacting the LEA Medi-Cal Billing Option Program. Highlights from the August 2, 2017 meeting include: Dr. Lindy Summers-Bair of the Medical Review Branch retired as of July 31, 2017....

Federal Audit of New Jersey School-Based Medicaid Programs Seeks $300M in Paybacks

The federal Office of Inspector General (OIG) released audit findings of New Jersey's school-based Medicaid programs in which they request the state refund over $300 million. Specifically, OIG determined: PCG, the state's contractor, improperly altered school employees’ responses to timestudies to indicate that their activities were directly related to providing Medicaid services when...

November Medi-Cal Bulletin for LEAs Posted—RTD Generation Phasing Out Over Next 12 Months

The November Medi-Cal Bulletin for California LEAs has been published to the DHCS website. One item of interest is the announcement that DHCS will be discontinuing the generation of Resubmission Turnaround Documents (RTDs) over the next 12 months. The discontinuation will happen in multiple phases, with a timeline to be published in a future monthly bulletin. DHCS notes, "the new process...