July 21, 2017
Area(s) of Interest: Payor Contracting Payor Issues and Reimbursement Practice Management Public Payors
Earlier this month, the Department of Health Care Services (DHCS) notified approximately 30,000 Medi-Cal providers that they were being "deactivated" because they had not submitted a claim or rendered services reported on a Medi-Cal claim in the last 12 months. The notices indicated that the deactivation date would be July 22, 2017. DHCS has, however, decided to not to proceed with the planned deactivation.
DHCS will instead be reconsidering what is defined as "inactivity" after the department was made aware that such deactivation would be problematic for some providers—particularly those who see Medi-Cal patients through a managed care Medi-Cal plans, who in many instances have contractual obligations to maintain active status with traditional fee-for-service Medi-Cal.
The DHCS Provider Enrollment Division has indicated that a rescheduled implementation of the mass deactivation will be announced at a later date.