Paradigm Publications
Latest Publications
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Paradigm Policy Digest: January 24, 2012
Paradigm HealthCare Services Jan 24, 2012
Paradigm's Policy Digest is a bi-weekly newsletter that highlights updates to our Policy Center, including: industry news, issue analysis, and other relevant Medicaid billing and reimbursement program content for schools and public agencies. -
2011 Legislative and Regulatory Review
Paradigm HealthCare Services Jan 18, 2012
Paradigm's Legislative and Regulatory Review is an annual review of federal and California state legislation and regulation that have impacted, or are projected to impact, school-based Medicaid billing and reimbursement programs; this publication is current at time of release, January 2012. -
Paradigm Policy Digest: January 5, 2012
Paradigm HealthCare Services Jan 05, 2012
Paradigm's Policy Digest is a bi-weekly newsletter that highlights updates to our Policy Center, including: industry news, issue analysis, and other relevant Medicaid billing and reimbursement program content for schools and public agencies. -
Paradigm Policy Digest: December 20, 2011
Paradigm HealthCare Services Dec 20, 2011
Paradigm's Policy Digest is a bi-weekly newsletter that highlights updates to our Policy Center, including: industry news, issue analysis, and other relevant Medicaid billing and reimbursement program content for schools and public agencies. -
Paradigm Policy Digest: December 7, 2011
Paradigm HealthCare Services Dec 07, 2011
Paradigm's Policy Digest is a bi-weekly newsletter that highlights updates to our Policy Center, including: industry news, issue analysis, and other relevant Medicaid billing and reimbursement program content for schools and public agencies. -
Policy QB Issue 003, October 2011
Paradigm HealthCare Services Oct 21, 2011
In this issue, updates on 1. California Special Education Mental Health Services (AB 3632), Provider Enrollment and Screening (CMS 6028) in California, and the Federal Budget Control Act of 2011; 2. Proposed changes to IDEA parental consent regulations; and 3. Affiliate projects. -
Policy Brief: National RMTS Study
Paradigm HealthCare Services Aug 01, 2011
As announced in June 2011, California is currently exploring increased use of RMTS starting in fiscal year 2012/13. To help California plan a smooth transition to the increased use of RMTS, Paradigm’s Policy and Research Division has investigated the experiences of 11 other states with this methodology. This Policy Brief contains the findings of our National RMTS Study. -
Policy QB Issue 002, August 2011
Paradigm HealthCare Services Aug 01, 2011
In this issue, updates on 1. California State Budget, AB 3632, Federal Budget Deal, and RMTS approval in California, 2. issue wrap-ups on the FMAP increase expiration and CMS 6028, and 3. affiliate updates. -
Policy Brief: AB 3632 Update, June 2011
Paradigm HealthCare Services Jun 01, 2011
The AB 3632 mandate on county mental health (CMH) departments was originally passed in 1984, but in the fall of 2010, the state suspended this requirement. Governor Brown’s May Revision of the state budget bill proposes a permanent elimination of the mandate, releasing CMH departments from responsibility for providing services to special education students in order to benefit from their IEPs. This brief discusses the role that LEA Billing and School-Based Medicaid programs may play, including limitations, in helping to fund this new responsibility. -
Policy QB Issue 001, April 2011
Paradigm HealthCare Services Apr 01, 2011
In this issue, updates on 1. CMS Policy Issues - Free Care Principle and Third Party Liability, 2. Health Reform 3. CMS 6028 (New Provider Screening and Eligibility Requirements), and 4. Issue Wrap-Up for Federal ARRA Stimulus Funds -
Maximizing Federal Funding for Health Care in Schools
Paradigm HealthCare Services Feb 10, 2011
This Advocacy Brief analyzes to major opportunities for improving school-based federal reimbursements through the LEA Billing program in California: 1. allowing billing for medically necessary transportation services as supported by the full extent of the California Code of Regulations, and 2. allowing billing for all necessary services provided to Medicaid-covered students, including regular education health services. -
Policy Brief: SB 231, 2009 Report to Legislature Released
Paradigm HealthCare Services Jan 01, 2011
In April 2000 a federal agency ranked California in the bottom quartile for school-based Medicaid reimbursement per eligible child. Since that time, the state’s Department of Health Care Services (DHCS) has been working under mandate to increase California’s average claim. This brief provides an overview of the 2009 Report to Legislature. -
Policy Brief: Free Care Challenge Update, December 2010
Paradigm HealthCare Services Dec 01, 2010
The Department of Health Care Services (DHCS) is building a case to challenge the federal Centers for Medicaid and Medicare Services (CMS) on a principle known as the “free care rule.” This brief provides an update to this challenge. -
2010 Legislative Review
Paradigm HealthCare Services Dec 01, 2010
Includes information on federal legislative items (CMS 6028, HR 3590 'Health Reform', HR 1586, and CMS 2361) and state-specific California legislation (AB 3632, and the 1115 Waiver); publication is current at time of release, December 2010. -
Policy Brief: AB 3632 County Mental Health Funding Suspended
Paradigm HealthCare Services Oct 01, 2010
On October 8, 2010, Governor Arnold Schwarzenegger signed the overdue 2010‐11 California Budget Bill and line item vetoed approximately $133 million intended to fund AB 3632 mandated services. This brief takes a closer look at the AB 3632 mandate and summarizes the debate over shifting responsibility for provision of all special education mental health services to schools. -
Policy Brief: ARRA Health-Related Spending Update
Paradigm HealthCare Services Jul 01, 2010
Federal agencies are currently distributing grants from the American Recovery and Reinvestment Act (ARRA) of 2009 throughout the United States. State and local organizations in California expect to benefit from $2.4 billion in spending on special education, and almost $750 million for other health-related programs and services. -
Background Brief: Third Party Liability and Other Health Coverage
Paradigm HealthCare Services May 01, 2010
Students with other health coverage (OHC), often referred to as third party liability (TPL), represent a unique challenge for Local Educational Agencies (LEAs) that seek to receive reimbursement for Medi-Cal covered health services through the LEA Billing Option program. This policy brief explores root causes of the OHC/TPL challenge and potential solutions. -
Background Brief: ARRA Health-Related Funding Opportunities for LEAs and LGAs
Paradigm HealthCare Services May 01, 2010
The American Recovery and Reinvestment Act (ARRA) of 2009 includes approximately $136.3 billion in health-related funding opportunities for state and local agencies, including an estimated $15.5 billion for agencies in California to provide or expand health and special education services. This Background Brief provides general information on ARRA funding and how this can impact your existing health programs while creating new opportunities for expanding services. -
Policy Brief: ARRA Special Education Funding
Paradigm HealthCare Services May 01, 2010
The American Recovery and Reinvestment Act (ARRA) of 2009 includes approximately $136.3 billion in health-related funding opportunities for state and local agencies. This includes approximately $1.3 billion allocated to California for special education of children from age five through 21. These dollars extended existing funding of the Individuals with Disabilities Education Act (IDEA), Part B, and can positively impact your MAA and LEA Billing Option programs.