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Attestation and UCR Submission Period Extended for CHDP Group Providers to Receive ACA Rate Increase

March 27, 2015

The attestation period and final day to add or update the Usual, Customary and Reasonable (UCR) charges for the Patient Protection and Affordable Care Act (ACA) increase has changed to April 17, 2015 for Child Health and Disability Prevention (CHDP) groups and clinics. Groups and clinics that have not already attested and submitted UCR data must do so on behalf of eligible providers for them to receive the payment increase. The increase will be issued mid-May 2015. This increase will only be paid for ACA-eligible CHDP services rendered in the years 2013 and 2014.

Important:

This extension period is granted solely to CHDP group providers who have not already successfully attested on behalf of their individual providers. Individual CHDP providers operating outside a group or clinic, and who successfully attested beforehand, were issued the interim payments in January 2015 on regular weekly Medi-Cal checkwrites. Also, CHDP providers may not use this extension period to update existing attestations and will therefore not be paid additional funds in accordance to their updates with this retrospective payment process.

Groups or Clinics Must Attest for Individual Providers
The following CHDP groups or clinics that have not already attested as a group and who bill claims for providers must attest eligibility for eligible providers. Providers are encouraged to contact their group or clinic for payment distribution.

  • County outpatient hospitals
  • Community outpatient hospitals
  • Free clinics
  • Community clinics
  • Multispecialty clinics
  • County clinics not associated with a hospital
  • Clinics (otherwise undesignated)
  • Physicians groups

  • Group providers may attest for their individual providers by completing the online ACA Self Attestation Form Primary Care Physicians and completing their UCR Submission (see instructions below). Instructions for completing the ACA Self Attestation Form are available in the Primary Care Physician Self Attestation Form Completion Instructions document.

    Additional Group Attestation Instructions
    CHDP groups or clinics should follow these additional instructions to complete the ACA attestation for their providers.

    • Enter the out-of-state medical or osteopathic license number of the owner or authorized official with the group or clinic in the License Number field. Alternatively, the group or clinic may use the license number they used to enroll in Medi-Cal as the license number on the form to complete their attestation.
    • If “Qualification 1” (board certification) is not applicable, select “Qualification 2” checkbox if the group or clinic meets the 60% threshold criteria.

    UCR Charge Submission Recommended for Newly-Attested CHDP Group or Clinic
    The UCR Web application is available on the Medi-Cal website for the newly-attested CHDP group or clinic to add or update UCR charges for CHDP services. The UCR application link is available under the “Elig” tab after the user logs in to the Login to Medi-Cal page using a valid existing user ID (National Provider Identifier).

    Instructions for submitting UCR information is available on the ACA Increased Payments for CHDP Primary Care Physicians – UCR Web Application Instructions document.

    Important:

    The final day to add or update UCR charges for CHDP services to ensure maximum ACA payment is April 17, 2015. Note that this day corresponds with the deadline for group and clinic providers to attest on behalf of their providers.

    Providers may refer to the ACA Increased Medicaid Payment for Primary Care Physicians page of the Medi-Cal website for additional information about the ACA payment increase.