October 8, 2018
RMTS for LEA Billing—DHCS Hosts Combined Stakeholder Meeting on Oct. 4, 2018
On Thursday, Oct. 4, 2018, the Department of Healthcare Services (DHCS) held the first LEA Billing and School Medi-Cal Administrative Activities (SMAA) combined meeting. Paradigm attended the meeting by webinar and below are the highlights.
There are 2 issues DHCS is still working out with CMS before formally submitting the final version of the SPA, which includes RMTS for LEA Billing, for...
October 5, 2018
LEA Ad-Hoc Advisory Workgroup Publishes August 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 August 1, 2018 meeting minutes include:
The Annual Report for FY 2017/18 has been posted to the DHCS website. No...
August 8, 2018
LEA Ad-Hoc Advisory Workgroup Publishes June 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 June 6, 2018 meeting minutes include:
All LEA's Data Use Agreements (DUA) with DHCS are set to expire December 1,...
July 19, 2018
July Medi-Cal Bulletin for LEAs Posted – LEA Provider Manual Updates
The July Medi-Cal Bulletin for LEAs has been published to the DHCS website.
One item of interest are updates to the LEA Provider Manual that reflect the change in withhold percentage from 1.5% to 2% and adding the location of service to the list of items that must be documented for all services (Paradigm clients, we have you covered here and there is no action required on your part).
For...
July 6, 2018
June Medi-Cal Bulletin for LEAs Posted – Updated Withhold Percentage & OT/PT Benefits Update
The June Medi-Cal Bulletin for LEAs has been published to the DHCS website.
Two items of interest include:
Effective for dates of service on or after July 1, 2018, the 1.5 percent withhold levied against Local Educational Agency (LEA) reimbursements, which covers audit administration and associated audit costs, is increased to 2 percent. The 1 percent administrative withhold for claims...
July 6, 2018
LEA Ad-Hoc Advisory Workgroup Publishes April 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 April 4, 2018 meeting minutes include:
OIG (the federal Office of Inspector General) is auditing the LEA Billing...
June 18, 2018
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...
May 16, 2018
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...
May 11, 2018
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...
February 23, 2018
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...