June 20, 2017
Area(s) of Interest: Payor Issues and Reimbursement
The California Department of Health Care Services (DHCS) recently announced it will implement a contingency plan for claim payment if the state budget is not enacted before the beginning of the 2017-2018 fiscal year on July 1. Although the state legislature passed a budget by the June 15 deadline, the Governor has not yet signed it. According to DHCS, providers should continue to submit claims for processing as normal, but payments for some programs may be delayed until the budget is signed.
Claims for the following services will be processed and adjudicated regardless of dates of service:Medi-Cal programCalifornia Children’s Services (CCS) program/Medi-CalChild Health and Disability Prevention (CHDP) program/Medi-CalFamily Planning, Access, Care and Treatment (Family PACT) ProgramAbortion
Claims submitted after June 22, 2017, for the following programs will be withheld regardless of dates of service.CCS-only (aid code 9D)CHDP services only (aid code 8Y)Genetically Handicapped Persons Program (GHPP) (aid code 9J)Optional Targeted Low Income Children’s Program (OTLICP)
Claims submitted by Every Woman Counts (EWC) will continue to be processed until contingency funding is exhausted.