News: LEA Billing

LEA Billing Program: TSP Lists for Consortiums

LEA Billing Program: TSP Lists for Consortiums On Monday, November 23, 2020, DHCS sent out an email providing direction on how the Time Survey Participant (TSP) List should be developed for LEAs that are part of a billing consortium under the LEA Billing program. According to the email, DHCS…

State Plan Amendment (SPA) 16-001 Targeted Case Management Services

On Thursday, October 22, 2020, DHCS announced that the Centers for Medicare and Medicaid Services approved State Plan Amendment (SPA) 16-001, with an effective date of January 2, 2016. For California LEAs billing for Targeted Case Management (TCM) services, SPA 16-001 now allows for TCM services to…

Roundup of Recently Published PPLs for California’s LEA Billing Program

California Department of Health Care Services (DHCS) has sent out another round of LEA Billing Policy and Procedure Letters (PPLs) as it continues to solidify implementation of State Plan Amendment 15-021. Paradigm’s roundup is below, including key takeaways. PPL 20-038, August 11 – Increase in…

LEA Billing Program Legislative Report FY 2018/19

As part of a requirement to submit annual reports to the California Legislature on the state of the LEA Medi-Cal Billing Option program, DHCS published their 2018/19 report on August 14, 2020. Information in this most recent Report to Legislature covers a wide range of topics, including a…

PPL 20-031: Random Moment Time Survey (RMTS) Participant Equivalency Process

On Friday, July 31, 2020, California DHCS released PPL No. 20-031 outlining the process and requirements for its RMTS Time Survey Participant (TSP) List Equivalency Request for LEA Billing purposes. This is good news for LEAs with providers who perform direct medical services as a primary job…

PPL 20-023: Submitting Quarterly Random Moment Time Survey (RMTS) Percentage Results to the Department of Health Care Services (DHCS)

On Tuesday, July 7, 2020, DHCS published Policy & Procedure Letter 20-023, titled “Submitting Quarterly Random Time Moment Survey (RMTS) Percentage Results to the Department of Health Care Services (DHCS)”. This PPL supersedes PPL 19-004R which was released in June, 2019 (click here for more on…

PPL 20-022: Notification of Random Moment Time Survey Requirement for the Local Educational Agency Medi-Cal Billing Option program

On Thursday, June 25, 2020, DHCS published Policy & Procedure Letter 20-022, titled "Notification of Random Moment Time Survey Requirement (RMTS) for the Local Educational Agency Medi-Cal Billing Option Program.” The information shared in this PPL 20-022 is specific to the changes that will…

PPL 20-014: CA Telehealth Policy Relative to the 2019 – Novel Coronavirus (COVID-19)

On Monday, May 11, 2020, DHCS released PPL 20-014, titled “Telehealth Policy Relative to the 2019 -Novel Coronavirus (COVID-19). The PPL specifies that during this national emergency, all LEA providers may bill for covered direct medical services provided via telehealth under the LEA Billing…

CMS Has Approved California State Plan Amendment 15-021

On April 28, 2020, CMS released an approval document written to DHCS confirming their approval of State Plan Amendment (SPA) 15-021 with an effective date of July 15, 2020. DHCS has yet to issue a formal announcement to LEAs, however the assumption is that implementation is still on track for July…

Executive Order to Expand Telehealth Services

On March 30, 2020, Governor Newsom issued executive order N-39-20 to temporarily expand telehealth services. This order provides protections to medical providers by relaxing certain state privacy and security laws so they may utilize telehealth services to minimize patient exposure and infections,…