Bills to Repeal Medi-Cal Cuts Pass Committee
This week AB 366 (Bonta) and SB 243 (Hernandez) passed their respective Health Committee on unanimous votes in both the Assembly and Senate. The bills would repeal the 10% Medi-Cal provider rate reductions and eliminate the claw back of the 10% to June 2011 for DME and medical supply providers along with other impacted providers. We now await the Governor's May Revise on the budget that will be issued on May 15th. Revenues continue to exceed budget projections in the current fiscal year. Once the May Revise is issued the respective budget sub-committees will complete their work and a final budget will be approved by June 15th.
Medi-Cal Edits on Claims from Rendering/Ordering Physicians
DHCS has not yet implemented any denials on any claim for service that was ordered by a physician who is either not enrolled in the Medi-Cal program or does not have an NPI number. That edit could be turned on later this year and we will alert you when that edit will be implemented.
In the meantime CAMPS has been in contact with DHCS and learned that they have begun notifying DME/medical supply providers if a current claim shows an ordering physician that does not meet that requirement. On the provider RAD it would show an 0588 denial code on the individual claim line. The claim will not deny but the provider will be alerted that there would be a problem with that ordering physician. We would appreciate an email from any member who has seen that denial code on a RAD in the last month.
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