Cov ntaub ntawv sau npe thiab ua raws li LEA Program
Rov qab mus rau LEA Home Page
Hloov tshiab: Lub Rau Hli 1, 2024
Yuav tsum tau LEA Qhov Kev Pabcuam Muab Kev Koom Tes Daim Ntawv Pom Zoo & Daim Ntawv Qhia Txhua Xyoo
The Provider Participation Agreement (PPA) and Annual Report (AR) are required for participation in the LEA Program. The PPA contains two exhibits: Exhibit A – Health Insurance Portability and Accountability Act (HIPAA) Business Associate Addendum (BAA), and Exhibit B – Data File Description. In addition to complying with the terms listed in the PPA, all LEA providers must abide by the terms listed in the BAA. The purpose of the BAA is to guard the privacy and security of protected health information and personal information that may be created, received, maintained, transmitted, used or disclosed pursuant to the PPA, and to comply with certain standards and requirements of HIPAA regulations. Exhibit B is a description of the data provided to the LEA via data tape match. LEAs do not need to sign or return Exhibits A and B to the Department of Health Care Services (DHCS).
Daim Ntawv Pom Zoo Siv Cov Ntaub Ntawv
LEA providers that designate a third-party billing vendor as their “Custodian of the Files” must submit a tri-annually DUA, which is signed by representatives of DHCS, the LEA, and the vendor. If a LEA provider does not utilize services of a third-party billing vendor and performs its own in-house billing, the LEA must submit a two-party DUA, which is signed by representatives of DHCS and the LEA.
Daim Ntawv Pom Zoo Muab Kev Koom Tes, Daim Ntawv Qhia Txhua Xyoo, thiab Daim Ntawv Pom Zoo Siv Cov Ntaub Ntawv thiab Cov Lus Qhia
(Email LEA.AnnualReport@dhcs.ca.gov kom thov PPA, AR, thiab DUA pob ntawv)
The SFY 2023-24 AR is due November 30, 2023. The SFY 2023-24 AR is available upon request. Please send requests, and submissions to LEA.AnnualReport@dhcs.ca.gov.
Thov siv Adobe Acrobat lossis Reader kom ua tiav cov ntawv.
Please direct any questions regarding the LEA PPA & AR to: LEA@dhcs.ca.gov
Txhua tus LEA uas nyuam qhuav tso npe tshiab yuav tsum xa PPA, AR, thiab DUA (yog tias tsim nyog) kom pib koom nrog LEA Medi-Cal Qhov Kev Xaiv Nqi Nqi Them Nqi.
Cov ntaub ntawv khaws cia
LEA Daim Ntawv Qhia Txhua Xyoo thiab cov ntaub ntawv txhawb nqa yuav tsum tau khaws cia los ntawm txhua tus LEA rau tsawg kawg peb xyoos txij li hnub xa mus rau DHCS thiab cov ntaub ntawv muaj nyob rau hauv yuav tsum tau lees paub los ntawm DHCS Cov Neeg Ua Haujlwm Kev Tshawb Fawb thiab Kev Tshawb Fawb, yog tias tsim nyog.
Copies of Prior Reporting Year’s PPA or AR
To obtain a copy of a prior year’s PPA or AR, please send your request to LEA.AnnualReport@dhcs.ca.gov.
Kev piav qhia ntawm Kev Tshawb Fawb thiab Kev Tshaj Tawm Tus Nqi
Local Educational Agencies (LEAs) enrolled in the Local Educational Agency Medi-Cal Billing Option Program (LEA BOP) must submit the annual Cost and Reimbursement Comparison Schedule (CRCS) to the Department of Health Care Services (DHCS) for audit by March 1 each year. DHCS’ Audits and Investigations staff will review the CRCS submission for completeness. After the CRCS is accepted as complete, DHCS will issue an interim or final settlement of the Medi-Cal share of each LEA’s costs within 12 months of the March 1 filing due date. The interim settlements were included as part of State Plan Amendment 15-021 and was initiated with the CRCS for fiscal year (FY) 2021-22 that was due on March 1, 2023. The interim settlement is based on 100 percent of the as-reported settlement due to DHCS and 60 percent of the as-reported settlement due to the LEA. Beginning with FY 2022-23 CRCS that was due on March 1, 2024, when a final settlement is not issued within 12 months of the March 1 due date, DHCS shall complete final settlement no later than 18 months after the date that the CRCS is submitted.
Tom qab qhov kev txiav txim ib ntus raug muab tso tawm, DHCS yuav ua qhov kev ntsuam xyuas CRCS los txiav txim siab txog qib ntawm CRCS audit. CRCS kev tshuaj xyuas yog ua raws li kev soj ntsuam tsawg kawg nkaus, kev tshawb xyuas tsis pub dhau, lossis kev tshawb xyuas hauv cheeb tsam thiab tej zaum yuav suav nrog kev tshuaj xyuas cov nqi tso cai raws li tsoomfwv txoj cai lij choj, xeev txoj cai lij choj, thiab LEA BOP txoj cai. DHCS yuav tham txog ib qho kev tshawb nrhiav CRCS nrog LEA thiab koom tes nrog LEA los daws cov lus nug, kev txhawj xeeb, lossis kev tsis pom zoo los ntawm cov txheej txheem tshawb xyuas. Thaum qhov sib txawv ntawm cov nyiaj tshaj tawm raws li tau sau tseg thaum xa tawm ntau dua 25 feem pua ntawm qhov kev txiav txim zaum kawg, DHCS yuav muab kev pab cuam rau LEA los pab LEA kom nkag siab qhov yuam kev kom nws yuav zam tau yav tom ntej.