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 program, with exception of services that preclude a telehealth modality, such as specialized medical…

Can California schools put safety measures in place in time to open early? Many district leaders skeptical

After Governor Newsom shared his four-phases to returning to normal life, with phase two including the re-opening of schools as early as late July or early August, many school officials and parents have been left skeptical, with more questions and even more concerns. “There is not going to be any sort of opening of schools before things are safe.” said Alex Caputo-Pearl, president of United…

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 1, 2020. A copy of the SPA package and approval letter can be found here: CMS Approval…

Governor Newsom Outlines Six Key Indicators the State Will Consider Before Modifying the Stay-at-Home Order

On April 14, 2020, Governor Newsom unveiled six key indicators that would be considered before modifying the state’s stay-at-home order, one of which is the ability for businesses, schools, and child care facilities to support physical distancing. Although he indicated no timeline for modifying the stay-at-home order, the Governor stated that the six indicators will serve as the framework for…

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, without the risk of being penalized. On April 3, 2020, the executive order was officially signed by…

Telehealth & LEA School-Based Services, An Open Letter

In response to the COVID-19 outbreak, Local Educational Agencies (LEAs) need immediate telehealth policy accommodations to continue providing and receiving funding for certain health services provided to children with disabilities. Paradigm has researched the current rules and policies as well as the current flexibilities being put in place as a response to coronavirus campus closures. Paradigm's…

Paper Remittance Advice Details Print Delay

On March 27, 2020 DHCS sent out a news flash advising that there will be a delay in receiving paper Remittance Advice Details (RADs) and Medi-Cal Financial Summaries by 4 business days. Due to this, DHCS is encouraging Providers who are not already signed up to receive PDF RADs to do so. To learn more, check out DHCS’ email here: DHCS Paper RAD Delay Additional instructions to view and…

Covered California & DHCS Team Up to Provide A Ready Path to Coverage

On March 20, 2020 Covered California re-opened their enrollment and announced they are extending the enrollment period for all eligible and uninsured until June 30, 2020. For more on eligibility and options, click here: Covered CA Concurrently, DHCS provided a quicker process for those who are Medi-Cal eligible or who may have recently become Medi-Cal eligible to acquire coverage immediately.…

LEA Medi-Cal Billing Option Program & Telehealth

On March 19, 2020, DHCS sent out an email reminding LEAs that speech therapy delivered to Medi-Cal eligible students via telehealth are billable through the LEA Medi-Cal Billing Option Program as set out in the provider manual and addressed in PPL 15-024R that was published by DHCS on June 28, 2016. In addition to this reminder, information was posted on the Medi-Cal website which identifies…

A Message to Our Clients, COVID-19 Response

The coronavirus (COVID-19) situation is evolving daily. Paradigm is closely monitoring direction and advice from the Centers for Disease Control & Prevention, and listening to our clients and staff to guide our actions. We have taken many steps to safeguard our operations so that the health of our clients’ programs is assured. All of our systems are ready, and we can assure confidentiality…