May Medi-Cal Bulletin for LEAs Posted—DHCS Transitioning Fiscal Intermediary Services

The May 2019 Medi-Cal Bulletin for LEAs has been published to the DHCS website. One item of interest in this month's Bulletin is that DHCS will be transitioning fiscal intermediary services from the current Conduent to DXC Technologies Services, LLC. This transition is projected to occur on October 1, 2019, and DHCS has said that payments should continue as normal as ensuring payments to...

SMAA Workgroup Publishes May 2019 Meeting Notes

The SMAA Workgroup posted the meeting notes from their May 1, 2019, SMAA Workgroup Meeting; highlights from that meeting include: Draft PPL 19-XXX, RMTS Sample Period—Continued the discussion from their April 17 meeting specifically regarding adjusting quarter four to accommodate the four day response period, see below: DHCS confirmed that reducing the quarter 4 sample period by 4...

DHCS’ Provider Enrollment Division (PED) Updates Ordering, Referring, and Prescribing (ORP) Provider Enrollment Rules

DHCS has confirmed that their Provider Enrollment Division (PED) has updated enrollment rules to ensure applications from registered, credentialed school nurses (RCSNs) and licensed educational psychologists (LEPs) will no longer be denied. Effectively immediately, LEP and RCSN providers may re-submit applications to enroll as Medi-Cal ORP providers in order to comply with the LEA Program’s...

LEA Medi-Cal Billing Option Program SPA 15-021 General Overview Training—Northern California

The California Department of Health Care Services (DHCS) has announced that in preparation for the approval of the State Plan Amendment (SPA) 15-021 by the Center for Medicare and Medicaid Services (CMS), they will be conducting two General Overview SPA 15-021 trainings for stakeholders that participate in the LEA Billing program. The announcement on April 26, 2019, included information about...

SMAA Workgroup Publishes April 2019 Meeting Notes

The SMAA Workgroup posted the meeting notes from their April 17, 2019, SMAA Workgroup Meeting; highlights from that meeting include: Draft PPL 19-XXX, RMTS Sample Period—Addressing submitted stakeholder comments and questions Moments assigned for the last minute of a shift; currently, the system may create a moment that begins the minute a shift ends (e.g., shifts ending at 5:00 pm may...

April Medi-Cal Bulletin for LEAs Posted

The April 2019 Medi-Cal Bulletin for LEAs has been published to the DHCS website. There was no LEA Billing program-specific information of note in this month's Bulletin. Click here to read the current or past Bulletins.

LEA Medi-Cal Billing Option Program SPA 15-021 General Overview Training—Southern California

The California Department of Health Care Services (DHCS) has announced that in preparation for the approval of the State Plan Amendment (SPA) 15-021 by the Center for Medicare and Medicaid Services (CMS), they will be conducting two General Overview SPA 15-021 trainings for stakeholders that participate in the LEA Billing program. The announcement today included information about the Southern...

DHCS Confirms Notification Timeline for RMTS Moments with PPL 19-006

On February 13, 2019, DHCS released PPL 19-006—Notification and Response Timeline for Random Moment Time Survey (RMTS) Moments which confirms the 1/4 notification timelines are effective for the 2019/20 fiscal year. This means TSPs will be notified one attendance day in advance of their moment and then have four attendance days after to submit their response.

DHCS Increases LEA Billing Reimbursement Rates for FY 2018/19

DHCS has confirmed that they are increasing the reimbursement rates for FY 2018/19 services and forward; this common, regular adjustment is done to account for inflation. Though the mileage rate went down by $0.02, LEAs can expect to see an average increase of 3% with some services reaching as high as 5% as soon as the erroneous payment correction (EPC) process begins. Click here to see the...

DHCS Issues New Provider Participation Agreement (PPA) Due March 1, 2019

On December 14, 2018, DHCS issued an updated Provider Participation Agreement (PPA) for the LEA Billing program. All participating LEAs must re-sign and submit the updated PPA by March 1, 2019. The updates made by DHCS include: removing the necessity for California Department of Education (CDE) to sign the PPA streamlining the language in the reinvestment of funds provision, though the...