SMAA Weekly Update #1 January 3, 2014
Happy New Year!
2014 is going to be a very exciting and a very busy year for School-based Medi-Cal Administrative Activities (SMAA) in California. The SMAA program has an ambitious agenda which includes working toward clearing the backlog of deferred invoices, finalizing a new statewide claiming plan, and making the transition from worker log to Random Moment Time Survey (RMTS).
The Department of Health Care Services (DHCS) is also going to work very hard to enhance the communication among all of the stakeholders in the SMAA program. To that end, DHCS is going to begin a series of weekly program updates which will be posted to the SMAA web site every Friday afternoon.
Reasonableness Test Criteria (RTC) / Interim Claiming Submissions
DHCS has been having trouble receiving the RTC/Interim Claiming document submissions that have been sent to date. Some of the individual file sizes have been so large they have overwhelmed the email system. Many of the submissions have simply not been received and the senders are not receiving error messages showing the submissions did not go through. As a result, DHCS has no way of knowing exactly which documents have been received. Therefore, a new system is currently being developed that will allow for a much more efficient mechanism for submitting large documents. The new system is called File Transfer Protocol (FTP) and is a system that is specifically designed to transfer very large files from one place to another via the Internet. We are currently working with our department’s Information Technology (IT) Division to get this system established and the LECs and LGAs will be notified once the system is in place. Once the system is established, each LEC and LGA will be required to resubmit the documents for the Interim Claiming and RTC processes. Until the FTP site is established, LECs and LGAs should NOT submit any documents to the SMAA email box for Interim Claiming and/or RTC. The FTP site should be established in the next few weeks and submissions may resume at that time.
The Revised SMAA Claiming Plan
Submission of the revised claiming plan to CMS has been delayed to mid-January to allow time for a discussion of the proposed plan with various school-based associations. CMS is aware of the situation and has informed DHCS that the original Milestone document which established the timeline for California to move to RMTS would be strictly enforced.
2012-2013 Quarter 2 SMAA Invoice Submission Deadline Extension
DHCS has determined that due to the implementation of RTC and the pre-approval process of the Participant Universe for 2013-2014 SMAA invoices, a 60-day extension is necessary for the submission of the 2012-2013 - Quarter 2 SMAA invoices until May 31, 2014. The new schedule for 2012-2013 invoice submissions is as follows:
• Quarter 1 March 31, 2014 (extension granted)
• Quarter 2 May 31, 2014 (extension granted)
• Quarter 3 June 30, 2014
• Quarter 4 September 30, 2014
If the school claiming unit has previously submitted invoices for SFY 2012-2013, DHCS will not process the invoices for payment until after the RTC is applied and adjustments are not required. However, if adjustments are necessary, the school claiming unit will be required to submit corrected invoices for processing and payment.