Key Takeaways from the DHCS LEA Billing Stakeholder Meeting - August 14, 2024
The DHCS LEA Billing Stakeholder Meeting on August 14, 2024, provided crucial updates and developments affecting LEAs. Below is a summary of the key points discussed, along with some insights on how these changes might impact your operations.
Significant Developments Affecting LEA Billing Operations
New Reimbursement Rates Effective from July 1, 2024
DHCS has updated the LEA BOP interim claim reimbursement rates, which they anticipate implementing by the end of September or October 2024. While some rates will decrease, the overall impact is expected to be net positive for LEAs, particularly in psychological, health, and speech assessments, with increases ranging from 6% to 10%.
Delay in CRCS Interim Settlements and ECRS Implementation
Some CRCS interim settlements for FY 2022/23 were incorrectly reduced by a 5% administrative fee, which should only apply to paid interim claims. Due to this error, DHCS has temporarily stopped issuing CRCS interim settlements until the issue is resolved, expected in late October 2024. Additionally, the Enterprise Cost Reporting System (ECRS) will not be used for the FY 2023/24 CRCS as originally planned. This delay means LEAs can expect to complete and submit the 2023/24 CRCS, due March 2025, in the customary manner.
Upcoming New DUA Template
DHCS is preparing an updated Data Use Agreement (DUA), which will need to be signed by all LEAs. Among the changes, DHCS plans to continue releasing re-enrollment data to LEAs to support their outreach efforts—great news since this data was expected to sunset in August 2024.
Mental Health Coordination with Managed Care Plans (MCPs)
Significant changes are underway in how MCPs coordinate mental health services for Medi-Cal enrolled students with IEPs. The new MCP contract requirements, effective in 2024, no longer exclude IDEA services, meaning every MCP must have a Memorandum of Understanding (MOU) with every LEA in their covered regions. A template MOU is expected in Spring 2025, and MCPs will now be involved in coordinating mental health services included in students’ IEPs.
Ad Hoc Workgroup and Potential Interim Payment Methodology Changes
The 2024/25 Ad Hoc Workgroup has been formed to explore the implications of the CMS Guide released late 2023, including consideration of a new interim payment methodology. While DHCS is not committed to changing the interim claims process, they will be surveying LEAs for feedback on the four new models available to states. Staying informed is crucial as any changes could impact how LEAs process claims, and we will keep you updated as more information becomes available.
CYBHI Multi-Payer Fee Schedule & LEA BOP Program Overlap
During the meeting, DHCS provided further details on mitigating the overlap between the CYBHI and LEA BOP programs. Payments received by LEAs through the Multi-Payer Fee Schedule for providers who participate in both the Fee Schedule and LEA BOP will be deducted from the annual cost report. Additionally, when an LEA is enrolled in both programs, all mental health-related claims for the general education population must be routed to the Fee Schedule. We commend DHCS’s efforts to secure a solution that mitigates potential double-dipping while ensuring the quarterly RMTS process for LEAs remains unaffected.
Technical Assistance Outreach for CRCS Variances
DHCS is enhancing its technical assistance outreach, particularly for LEAs that experience more than a 25% variance between their submitted CRCS and the adjustments applied by auditors. This metric is being used to trigger support efforts to help LEAs understand and close any significant gaps.
These updates signal significant shifts in the administration of LEA BOP and related programs. Staying proactive and informed will be essential in navigating these developments effectively. As always, we remain committed to providing the latest information and supporting you through these changes. Be sure to check our News section regularly for critical program updates, and don’t hesitate to reach out to us with any questions or for personalized support. You can also access DHCS’s archive of these meetings by clicking here.
