DHCS Expands Scope of Data Use Agreement for California Schools
As part of ongoing efforts to sustain Medi-Cal coverage for school-aged children in light of the Consolidated Appropriations Act of 2022, the California Department of Health Care Services (DHCS) recently released an updated Data Use Agreement (DUA) template for schools. The new DUA allows schools to use the eligibility data they gather as Medi-Cal Providers to inform their Medi-Cal outreach efforts.
Paradigm, a leading provider of Medi-Cal billing services, recently shared some insights on the updated DUA during their Education Series General Seminar. In this post, we'll provide an overview of the key changes and considerations for schools.
Background
The Consolidated Appropriations Act of 2023 (CAA) was enacted on December 29, 2022, ending continuous coverage as of March 31, 2023. This means that millions of Medicaid beneficiaries must go through a coverage redetermination process. In California, DHCS has been working to educate and inform beneficiaries on the importance of updating their contact information to ensure timely delivery of their Medi-Cal benefit renewal packages for redetermination.
At the same time, there has been much discussion about how schools can leverage the eligibility data they have access to in order to bolster outreach to students. In response to this discussion, DHCS amended the terms of the DUA so that schools can use eligibility data to inform their outreach efforts.
Nuances to Understand
First and foremost, California LEAs should note that they are not required to sign the updated DUA. Any active DUA that is on file with DHCS is sufficient until next year. As California schools consider signing the updated DUA, there are a few nuances to understand:
Time spent on Medi-Cal outreach and application assistance is reimbursable through SMAA, and is not discounted by the Medi-Cal Eligibility Ratio (MER). This means that schools can receive reimbursement for the time spent on outreach efforts to beneficiaries, regardless of their MER.
By signing the updated DUA, schools can use eligibility lookup data received on their behalf for outreach purposes. This eligibility data can help schools better target their outreach efforts and connect with potential beneficiaries.
The eligibility data schools have access to is retrospective, showing whether a student was covered and the month coverage ended. This information can be useful for schools that want to track changes in Medi-Cal coverage among their student population over time.
We recommend that schools carefully consider whether retrospective data is useful for their outreach programs, and make an informed decision about whether to sign the updated DUA. By doing so, they can access valuable information that can inform their outreach efforts and help ensure that eligible beneficiaries receive the coverage they need.
