Angel Rodriguez - DHCS; Connie Flores - DHCS; Jacqueline Leto – DHCS

Kim Oreno; Jaison Chand; Steve Grau; Chris Micheli; Fred Sundquist; Alan McNany; Jimmy Pierson; Todd Valeri; Dale Feldhauser


Connie began with some background. Her division is the fee for service rate development division. Develops outpatient and long term care facility rates. Angel handles rate setting for ambulance. QAF bill gives opportunity to increase rates with rate increase funded via add on determined by upcoming data collection process. The add on amount, once determined, will be posted.  Aiming for 7/1/18 effective date. They are required to submit State Plan Amendment (SPA) by 6/30/18. They hope to submit the SPA by February 1. Privates are not involved in creating the SPA. They will post public notice on dept’s website before the end of the year. There will be a 30 day public comment period because of the rate change and the SPA will be provided. There’s a SPA webpage that lists all proposed upcoming SPAs. DHCS also has to submit an access study report (info included could be # of providers by locality, expenditures, rate comparison, etc) and information on the public comments.

First reporting deadline - $100/day late fee not yet being assessed. Angel and his group are setting up a website, Ground Emergency Medical Transportation page. Info will be posted there, form that they’re asking providers to use, instructions, sample form. They did similar webpage for clinical labs and used that as template. That website will go live in 2 or 3 days. The webpage has been sent off to legal folks for review. November 15th is new deadline – trying to keep everything on track and moving forward. She thinks they’ll be able to take late submissions and won’t be super strict enforcing the late fees at first. They are developing a mailing list of providers who bills for the 3-4 codes that are outlined in the bill. A direct mailer will be sent to them. An email will be sent anytime there is an update. A newsflash will go out on dept website. They are trying to capture as many providers as possible. Kim forwarded CHP list to Chris to forward to DHCS. Need to send names & email addresses of who to include on email blasts. An email inbox has been set up to field questions. Ancillary codes and expenses that are on claims with the 3-4 codes need to be included in the reporting. Dry runs will not get the add on and they don’t need the data. Connie will send a sample of the form to Chris and Chris will distribute.

Potential outcome of public comment – DHCS has to address any concerns from the public and provide evidence to CMS that those concerns have been addressed. Hard to say what they’ll be and what the effect will be.

Meeting concluded at 1:38pm.

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