January 24, 2019
Area(s) of Interest: Payor Issues and Reimbursement Practice Management Public Payors
The Medi-Cal Provider Enrollment Division (PED) recently announced that it will no longer accept paper enrollment forms, effective March 5, 2019. Medi-Cal enrollment applications and forms will move entirely to the e-form application process through the California Department of Health Care Services’ (DHCS) Provider Application and Validation for Enrollment (PAVE) portal. While PAVE was anticipated to eventually replace the paper application process, DHCS moved swiftly to eliminate the paper option for providers after the September PAVE update (3.0).
Prior to the announcement, PED did seek feedback from stakeholders including the California Medical Association (CMA). Based on that feedback, agreed to expand the notice period of this change from 30 days to 60 days. It is also offering additional PAVE training to ensure users are prepared to begin using the online enrollment process.
CMA also urged PED to allow an exception for those doctors who still wanted to submit paper applications. To request an exception, submit the request in writing to:
Department of Health Care Services
Provider Enrollment Division
P. O. Box 997412
Sacramento, CA 95899-7412
The request should include a detailed explanation why they cannot use PAVE and include any supporting documentation. PED will review these requests on a case by case basis to determine if an exemption should be granted.
The PAVE system, initially launched on November 18, 2016, transformed Medi-Cal provider enrollment from a manual paper-based process to a web-based portal that providers could use to complete and submit their applications and verifications, and to report changes.
According to DHCS, the process for completing an application through the PAVE system is dramatically streamlined, dropping the average to complete an application from 1.75 hours to 0.7 hours. DHCS also reports its average provider application processing time has dropped from an average of 75 days to 59 days, with the goal to eventually achieve a 30-day turnaround timeframe.
For more information about PAVE, see the DHCS PAVE FAQ.