- Am I affected by the August hold?
A: The August hold will affect Medi-Cal institutional providers. Payments to Medi-Cal practitioner providers and non Medi-Cal providers are not impacted. Also, Local Educational Agencies (LEA), designated public hospitals, small and rural hospitals are exempt from the August hold.
- When will I receive my payments?
A: The State of California did not enact the Fiscal Year 2008-09 budget by June 30, 2008. The Department of Health Care Services (DHCS) directed the fiscal intermediary (EDS) to continue to pay Medi-Cal practitioners per federal mandate and continue to pay Medi-Cal institutional providers through the Medical Providers Interim Payment (MPIP) fund until the loan is exhausted, which will be July 31, 2008. After that date, Medi-Cal institutional providers will not receive payment until a budget is enacted.
- What happens if the budget is signed after August 1, 2008?
A: Please continue to check Medi-Cal Update bulletins or the Medi-Cal Web site for updates.
- Can I refuse service to my patients since I am not receiving any payments for services rendered?
A: DHCS appreciates providers seeing patients receiving State-covered health care services during this time. Please continue rendering services and billing for those services. Upon completion of the August hold providers will be reimbursed for services rendered.
- Why is the Department of Health Care Services (DHCS) holding payments from only specific providers?
A: The August hold will affect Medi-Cal institutional providers, so payments to Medi-Cal practitioner providers and non Medi-Cal providers are not impacted. Also, Local Educational Agencies (LEA), designated public hospitals, small and rural hospitals are exempt from the August hold.
- How was the August payment hold determined?
A: Legislation (Chapter 3, Statutes of 2007-08) determined that payment to Medi-Cal institutional providers of health care services may be held for a period of one month.
- Do I continue sending my claims to Medi-Cal?
A: Yes. Continue to send claims in for processing. Medi-Cal claims processing will not stop and will keep claims timely.
- Will I continue to receive RADs during hold or no-budget periods?
A: You will receive RADs which contain any claims paid on that warrant or EFT along with denied and suspended claims. Claims held as a result of no-budget/hold periods will not be reported on the RAD.
