DHCS Begins Recouping Retroactive Medi-Cal Radiology Cuts May 11, 2016 In 2010, the California state budget included cuts to Medi-Cal radiology rates, stipulating that the maximum reimbursement rates for radiology services could not exceed 80 percent of the Medicare rate for the same or similar services. The Department of Health Care Services (DHCS) did not, however, implement the rate reduction until July 20, 2015, with retroactive cuts going back to October 2012. To recoup the retroactive cuts, DHCS recently announced that it would be offsetting overpayments against amounts due. Physicians affected by this retroactive recoupment were notified by ... May 11, 2016 Medi-Cal DHCS, Medi-Cal, Radiology 0 0 Comment Read More »
Low Income Health Plan Transition Begins January 1 From CMA's December 16, 2013, CMA Alert As part of a multi-faceted Medi-Cal expansion, the California Department of Health Care Services (DHCS) will be transitioning roughly 600,000 enrollees with incomes at or below 133 percent of the federal poverty level from the Low Income Health Program (LIHP) to Medi-Cal managed care effective January 1, 2014. LIHP is a county-based program established under California’s “Bridge to Reform” SS1115 Medicaid Demonstration Waiver, and was created to prepare for health coverage options authorized through the Affordable Care Act of 2010 (ACA). The program provides ... December 18, 2013 Medi-Cal DHCS, LIHP, Medi-Cal 0 0 Comment Read More »
DHCS Pays $65 Million to Primary Care Physicians in Initial Retroactive Medi-Cal Rate Increase Payment; Second Payment Expected Soon From CMA's December 16, 2013, CMA Alert The California Department of Health Care Services (DHCS) is expected next week to make its second round of retroactive interim payments to primary care physicians who have attested to their eligibility for the rate increases called for under the Affordable Care Act (ACA). These primary care payment increases have been put in place by the federal government in an effort to recruit more primary care physicians to treat low-income patients who will be newly eligible for health coverage in 2014. Although under the ACA ... December 18, 2013 Medi-Cal DHCS, Medi-Cal 0 0 Comment Read More »