Key Takeaways from the DHCS LEA Billing Stakeholder Meeting - January 31, 2024
The DHCS LEA Billing Stakeholder Meeting on January 31, 2024, brought forth a series of important updates and strategic shifts. Click here to access the full agenda. To ensure you're fully informed, we’ve highlighted the key points discussed during the session.
Significant Developments Affecting LEA Billing Operations
1 - Administrative Fee Changes
A pivotal shift comes with AB 483’s impact on administrative fee withholdings. Starting January 2024, DHCS will withhold up to 5% from LEA payments – a substantial increase from the historical 1% for claims processing and an additional 2% with an annual cap of $2.5M annually. This move marks a significant policy change that LEAs should prepare for.
2 - Organizational and Leadership Updates
The division formerly known as Audits & Investigations (A&I) has transformed into the Financial Review Outpatient Behavioral Health Division (FROBHD). This rebranding comes with new leadership, including Stacy Fox as Division Chief, Brandon Smith overseeing the Special Programs Section, and Said Mursal stepping in as the new LEA Billing Audits Manager.
3 - CRCS Settlements and Audits Timeline
FROBHD has released an updated schedule for outstanding CRCS settlements and corresponding audits, including amendments. The detailed timeline is as follows:
| Fiscal Period | Final Settlement Due | % of Settlements Concluded |
|---|---|---|
| 2015/16 Amended | June 1, 2025 | 42% |
| 2016/17 Amended | September 1, 2025 | 10% |
| 2017/18 Amended | September 1, 2025 | 10% |
| 2018/19 Amended | December 1, 2024 | 0% |
| 2019/20 | March 1, 2025 | 0% |
| 2020/21 | March 1, 2024 | 90% |
| 2021/22 | March 1, 2024 | 22% |
4 - Federal Medicaid Assistance Percentage (FMAP) Update
The FMAP rate has reverted to its standard share of 50% as of January 1, 2024. LEAs should note this change in federal contribution to their financial planning.
5 - Status of the Re-enrollment Data Use Agreements (DUA)
The Re-enrollment DUA, introduced in November 2023, is designed to grant temporary access to extended information about students' Medi-Cal coverage. DHCS is still working on finalizing the review and approval of these agreements. Once executed, the DUA will enable LEAs to receive advance notice of impending Medi-Cal coverage expirations, until September 1, 2024. The goal to make the re-enrollment process more efficient is ongoing.
Stay tuned to our blog for more detailed analyses of new developments and insights on how they may impact your LEA. Our goal is to empower LEAs with knowledge to navigate these changes effectively.
