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…

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…

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…

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…

DHCS is Hosting Training Series

On April 3, 2020, DHCS released an update on their training series schedule. The training session on May 6th has been cancelled and DHCS will be hosting all upcoming trainings via webinar.  See revised schedule below:  In preparation for the approval of State Plan Amendment (SPA) 15-021 that is anticipated to be approved by Centers for Medicare and Medicaid Services (CMS) on or before May 11,…

DHCS Confirms State Plan Amendment (SPA) 15-021 is Officially ‘On the Clock’

On Tuesday, February 11, DHCS sent an email announcing they had formally submitted the State Plan Amendment (SPA)15-021 to Centers for Medicare and Medicaid Services (CMS), who has 90 days to review the package. On Wednesday, February 12, during a DHCS Workgroup meeting, DHCS confirmed that CMS accepted the submission and will adhere to the expected decision date of May 11, 2020. DHCS advised…

DHCS News Roundup

Over the past week, DHCS sent a handful of email announcements to LEAs regarding the operations of LEA Billing.  For your information, the roundup is below:  2017/18 CRCS Submission Docs Update   On Sept. 27, 2019, DHCS posted the template documents for the 2017/18 CRCS. In addition, DHCS posted PPL 19-019 (Sept 18, 2019), which calls for a small change in how to submit your CRCS to DHCS.…

Healthy Schools Campaign Hosts Free Webinar on School Medicaid Opportunities

Date: September 24, 2019 Time: 1PM - 2PM, CDT About the Webinar This introductory webinar will explore the following questions: - What is Medicaid and what does it cover—in and out of school? - How can school districts leverage Medicaid to enhance school health services? - What is the free care policy reversal and how are states leveraging this opportunity to expand their school-based…