Medi-Cal Policy Change Effective Today
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If you are a provider of Medi-Cal hearing aids this is a reminder that today, January 15, 2013, is the effective date for implementation of the reimbursement policy change.
The policy change no longer reimburses providers on single unit wholesale cost but now reimburses on provider acquisition cost plus the monaural fee or binaural fee. Medi-Cal's official policy change notice is provided below.
HHP is concerned that at the new reimbursement rates, access to Medi-Cal hearing aids will be severely limited across the state. Many providers have signaled they can no longer afford to remain in the program. HHP is continuing to work with providers, DHCS and legislators to educate all stakeholders of the consequences of this policy change and to educate the value of our members services.
HHP will keep our members posted of our efforts.
Don Tucker, President
HHP
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Hearing Aid Reimbursement Police Change
December 14, 2012
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Effective for dates of service on or after January 15, 2013, the Department of Health Care Services (DHCS) is revising the reimbursement policy for hearing aid codes. DHCS is changing the definition of "one unit wholesale cost."
The existing definition is: The "unit price" or the "single unit price" as identified in the manufacturer's wholesale catalog not including rebates, discounts, taxes or any other factors.
The new definition is: The "unit price" or the "single unit price" as identified in the manufacturer's wholesale catalog, less rebates, discounts, or other reductions in price and not including taxes.
The amended definition is issued pursuant to Welfare and Institution Code (W&I Code), Section 14105.49, which allows DHCS to implement the change by provider manual or bulletin. DHCS is implementing this revised reimbursement policy following significant analysis and review of stakeholder feedback.
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