SMAA Program Update - June 16, 2016
A. Department-Wide Deferral
DHCS administers many Medi-Cal programs in California for the federal Centers for Medicare and Medicaid Services (CMS). When certain programmatic issues are identified, CMS may place a deferral on one or more Medi-Cal programs. These deferrals prohibit DHCS from accessing the federal funds necessary to administer the various programs.
Currently, CMS has instituted several department-wide deferrals on other DHCS programs outside of the SMAA program. Although these other program deferrals do not impact the SMAA program directly, they have created a delay in obtaining the federal funds necessary to make retroactive payments for dates of service beginning with state fiscal year (SFY) 2009/10 Quarter 3 through SFY 2011/12 Quarter 1. Invoices submitted for these dates of service were submitted to CMS as placeholders corresponding to federal fiscal year (FFY) 2012 and FFY 2013 in order to preserve the two-year claiming limit. DHCS is working closely with CMS to clear all outstanding program deferrals that are hindering the release of federal funds and will provide updates as we receive additional information.
B. Revised Invoices for Paid Deferred Claims
All Local Educational Agencies (LEAs) that submitted overpayment refund warrants for revised invoices on paid deferred claims from SFY 2009/10 through SFY 2011/12 will receive refunds for those payments once the DHCS department-wide deferral is resolved. The regional Local Educational Consortia (LEC) or Local Governmental Agency (LGA) that administers the SMAA program for your LEA will be notified prior to the refunds being issued. All paid deferred claims can be found at the following links:
Last modified on:
6/16/2016 4:40 PM