Certified Public Expenditure (CPE)
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CPE is a mechanism for public entities (in this case, Local Educational Agencies (LEAs)) to certify that the funds spent on Medicaid services are eligible for federal matching funds. Since Medicaid is a state-federal partnership, the Local Educational Agency Medi-Cal Billing Option Program (LEA BOP) has to have a way to certify that funds used to draw down federal dollars meet certain requirements. This means that the LEA BOP requires the following components to ensure participating LEAs comply with the program:
- A cost report, Cost and Reimbursement Comparison Schedule (CRCS), for LEAs to certify their actual costs for providing approved health-related services.
- LEAs must certify that they are using nonfederal sources as the match for reimbursement through the LEA BOP.
- LEAs are subject to annual audits to confirm the final amount that they will receive based upon meeting program compliance.
Because CPE's take a long time to get to the final settlement, LEAs receive interim reimbursements for allowable services by submitting claims throughout the school year. Once the Department of Health Care Services (DHCS) completes the audit to verify costs on the CRCS, DHCS will recoup any overpayment amount or pay the difference to the LEA if the certified cost exceeds interim reimbursements.
