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  • OIG Notice to California Regarding Audit of School Medicaid Administrative Claiming Program
  • San Francisco Superior Court, Case No. 509-499, SFUSD vs. California DHCS: Final Judgment
    The final judgment in this case was issued in favor of San Francisco Unified School District and stipulates that the district is entitled to reimbursement for certain medical services provided to Medi-Cal eligible regular education students.
  • DHCS Report to Legislature on the LEA Billing Option Program, May 2012
    Report period: April 2011 through May 2012.
  • PPL 13-001
    This Policy and Procedure Letter (PPL) notifies LEAs participating in the LEA Medi-Cal Billing Option Program that specific provisions set forth in the California Code of Regulations (CCR), Title 22 Sections 51323(a)(2)(A), 51323(a)(3)(B), 51231.1(f), and 51231.2(e), shall not apply to medical transportation eligible to be billed under the LEA Medi-Cal Billing Option Program.
  • PPL 12-012
    The purpose of this Policy and Procedure Letter (PPL) is to reiterate federal and state policy regarding the prohibition on claiming Federal Financial Participation (FFP) for contingency fee contracts.
  • Example CMS Deferral Release Notification Letter
    This example correspondence from the Department of Health Care Services (DHCS) to a California regional agency announces the release from CMS deferral of a contracted school district participating in the school MAA program.
  • CMS Notice to California of School MAA Claims Deferral and Order to Revise Claiming Methodology Beginning FY 2012-13
    Official correspondence from the federal Centers for Medicare and Medicaid Services (CMS) to California's Department of Health Care Services (DHCS) regarding a deferral of school MAA claims submitted for payment on the December 31, 2011 Form CMS-64. This notice also includes an order on DHCS to revise the time survey methodology and statewide claiming plan beginning July 1, 2012.
  • PPL 12-009
    Electronic Signatures for Claiming Federal Reimbursement for Medi-Cal Administrative Activities (MAA)
  • San Francisco Superior Court, Case No. 509-499, SFUSD vs. California DHCS: 10th Joint Status Report
    Joint status report filed in the San Francisco Superior court in the case of SFUSD vs. California DHCS over rights to receive payment for "regular education" free care type health services.
  • San Francisco Superior Court, Case No. 509-499, SFUSD vs. California DHCS: Order Re: Order to Lift Stay of Action
    San Francisco Superior Court order to lift the stay of action in the case of SFUSD vs. California DHCS over rights to receive payment for "regular education" free care type health services; this stay of action, initiated in October 2009, allowed DHCS time to challenge the federal CMS on its application of the free care rule and obtain approval to receive federal payment on behalf of SFUSD for future regular education claims.
  • PPL 12-008
    Notification of California State Plan Amendment Number 05-010 Regarding the Supervision Requirements for Speech-Language Pathologists Under the Local Educational Agency Medi-Cal Billing Option Program
  • PPL 12-006
    PPL 12-006, LEA Medi-Cal Billing Option Program - Changes To Standardized Account Code Structure (SACS) Resource Code 5640, is related to the policy change originally set out in PPL 11-013 regarding the reinvestment of LEA Billing reimbursements in the MAA program. The PPL reiterates that Resource Code 5640 revenues will no longer be considered federal income for the purpose of the LEA Billing program, announces the official change to the California Department of Education (CDE) SACS coding structure to reflect the policy change, and outlines the incorporation of this policy into the CRCS for LEAs dating back to FY 09/10.
  • 2012-13 California SMAA Time Survey Form
    An electronic copy of California's SMAA Time Survey form for FY 2012-13.
  • DHCS Report to Legislature on the LEA Billing Option Program, May 2011
    Report Period: April 2010 through May 2011
  • PPL 11-013
    Notification that Local Educational Agencies participating in both Local Educational Agency Medi-Cal Billing Option and School-Based Medi-Cal Administrative Activities may include SACS resource code 5640 in their SMAA invoice.
  • PPL 11-011
    Notification of an approved interim claiming methodology for Local Governmental Agencies (LGAs) to obtain Medi-Cal Administrative Activities (MAA) reimbursements through the CMAA Program, beginning with Fiscal Year 2010/11.
  • PPL 11-007
    Random Moment Time Survey (RMTS) Methodology Plan Guidelines for Local Educational Consortia and Local Government Agency for School-Based Medi-Cal Administrative Activities
  • PPL 11-002
    Contingency Fee Contracts Policy (CMAA program). This policy and procedure letter is to reiterate our policy that, in general, Federal Financial Participation (FFP) is not available for the costs of Medicaid contingency fee contracts.
  • 2011-12 California SMAA Time Survey Form
    An electronic copy of California's SMAA Time Survey form for FY 2011-12.
  • SMAA Manual FY 2012-13
    Combined / Searchable Version with Bookmarks and Hyperlinks For Easier Reference
  • SMAA Manual FY 2011-2012
    Combined / Searchable Version with Bookmarks and Hyperlinks For Easier Reference
  • SMAA Manual FY 2010-2011
    Combined / Searchable Version with Bookmarks and Hyperlinks For Easier Reference
  • 2010 CMAA LGA Provider Manual
    The California County-Based Medi-Cal Administrative Activities Manual (CMAA Manual) intends to help local governmental agencies (LGAs: counties and chartered cities) participate in the CMAA program and maintain proper documentation for their claiming units. This is the original LGA provider manual, last published in 2010 prior to the development and implementation of a new time survey methodology for CMAA claiming expected to be released for FY 2012-13.
  • PPL 10-007
    Certified Public Expenditure (CPE) Requirements for Federal Financial Participation (FFP) for CMAA: This Policy and Procedure Letter (PPL) clarifies existing requirements and additional legislation for Federal claiming for CMAA.
  • DHCS Report to Legislature on the LEA Billing Option Program, May 2010
    Report Period: April 2009 through May 2010
  • San Francisco Superior Court, Case No. 509-499, SFUSD vs. California DHCS: Order Re: Order to Show Cause
    San Francisco Superior Court decision in favor of San Francisco Unified School District (SFUSD) over rights to receive payment for "regular education" free care type health services; this order included information regarding a stay of action imposed to allow DHCS time to challenge the federal CMS on its application of the free care rule and obtain approval to receive federal payment on behalf of SFUSD for future regular education claims.
  • DHCS Report to Legislature on the LEA Billing Option Program, March 2009
    Report period: April 2008 through March 2009
  • DHCS Report to Legislature on the LEA Billing Option Program, September 2006
    Report Period April 2005 to March 2006 (With Additional information for January 2003 through March 2005)
  • California Attorney General Opinion No. 06-1011: Speech-Language Equivalency
    An opinion issued by California Attorney General, Bill Lockyer, on the equivalency of preliminary and clear credentialed speech-language pathologists to federal standards governing Medicaid reimbursement to speech pathologists.
  • LEA Medi-Cal Billing Option Program Frequently Asked Questions
  • LEA Glossary of Terms
    as published on the DHCS website, pulled on June 30, 2011
  • Medi-Cal Provider Manual Part 1 - Medi-Cal Program and Eligibility
    A direct link to the most updated sections of California's Department of Health Care Services' Medi-Cal Provider Manual, Part 1
  • Medi-Cal Provider Manual Part 2 - Billing and Policy
    A direct link to the most updated sections of California's Department of Health Care Services' Medi-Cal Provider Manual, Part 2; includes detailed instruction on the operation of California's LEA Billing Option program.
  • Medi-Cal Provider Manual Part 2 - LEA Billing Option Program Sections (Combined File)
    A direct link to an always-current excerpt from the California Department of Health Care Services' Medi-Cal Provider Manual, specific to the operation of the LEA Billing Option Program.