Family PACT Update

June 2018 | Bulletin 129

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1. Medi-Cal Checkwrite Schedule Update for Fiscal Year 2018 – 2019

Effective July 1, 2018, the checkwrite schedule is updated for fiscal year 2018 – 2019. The schedule reflects warrant release dates and Electronic Fund Transfer (EFT) dates of deposit for all programs including the following:

This information is reflected in the following provider manual(s):

Provider Manual(s) Page(s) Updated
Part 1 check (1–3)
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2. Phase 3: RTD Generation is Discontinued

The Department of Health Care Services (DHCS) has eliminated the generation of Resubmission Turnaround Documents (RTDs) (Form 65-1). The discontinuation of RTDs will both increase claims processing efficiency and reduce costs.

RTDs were discontinued in multiple phases. The first phase was implemented in November 2017 and the second phase was implemented in February 2018. The third and final phase implemented in May 2018. The new process will deny claims submitted with questionable or missing information instead of generating an RTD. The generation of RTDs has been completely discontinued and providers will no longer receive RTDs. Any current unprocessed RTDs in the providers possession may still be returned to the DHCS Fiscal Intermediary by the due date listed on the RTD and will be processed as normal.

Additional changes to the provider manual will be announced in a future monthly bulletin. Providers are encouraged to routinely check the Medi-Cal website for more information.

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3. Pharmacist Furnishing of Medications under Statewide Protocol

All medications authorized by Senate Bill 493 and subsequent amendments of the Business and Professions Code (B&P Code), Section 4052 are reimbursable by the Medi-Cal program for pharmacy claims, including drug costs and dispensing fees, when furnished by pharmacists within their scope of practice. Pharmacists do not need to be enrolled as Ordering, Referring and Prescribing (ORP) providers when they are the prescriber on record using their own National Provider Identifier (NPI) for these claims.

The following medication classes are currently exempt from ORP enrollment for reimbursement of pharmacy claims, including drug costs and the dispensing fees, when furnished by pharmacists within their scope of practice:

When the Department of Health Care Services (DHCS) implements reimbursement for the professional services associated with furnishing the above medication classes, as authorized under Assembly Bill 1114 and Welfare and Institutions Code (W&I Code), Section 4132.968, the pharmacist providing such services must be an approved ORP provider. Additionally, all pharmacists furnishing medications under collaborative practice agreements according to B&P Code, Sections 4052.1, 4052.2 and 4052.6 will be required to be ORP providers in order for pharmacy claims to be reimbursed. Therefore, DHCS encourages all pharmacists to become ORP providers with the Medi-Cal program.

Providers should refer to the Ordering, Referring and Prescribing (ORP) web page on the Medi-Cal website for more information.

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4. 2018 Rate Adjustment for Clinical Laboratory Services

Effective retroactively for dates of service on or after January 1, 2018, reimbursement rates for clinical laboratory services are adjusted. An Erroneous Payment Correction (EPC) will be initiated to reprocess affected claims. No action is required of providers. Providers may refer to the Medi-Cal Rates page of the Medi-Cal website for current reimbursement rates.

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5. Reminder: VeriFone VX 520 POS Device to Decommission in July 2018

In July 2018, the VeriFone VX 520 Point of Service (POS) device will be decommissioned. Transactions from these devices will no longer be accepted or processed after decommission. A final notification letter will be mailed out instructing providers to return the devices. Providers may contact the POS Help Desk at 1-800-541-5555 (option 5, followed by option 6) for information about the decommission and to learn about available alternative options.

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6. Reminder: Do Not Staple Paper Claim Forms

Providers are reminded to not staple paper claim forms as staples delay claims processing. For more general reminders about paper claim submission, providers are encouraged to check the Billing Tips: Paper Claims page of the Medi-Cal website.

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7. Provider Orientation

Medi-Cal providers applying to become a Family Planning, Access, Care and Treatment (Family PACT) provider are required to attend a Provider Orientation per Welfare and Institutions Code (W&I Code), Section (§) 24005(k). The Provider Orientation training is delivered online and in person and includes information on comprehensive family planning, program benefits and services, client eligibility, provider responsibilities and compliance.

Each provider's service location is required to be certified for enrollment in the Family PACT Program. Applicants who are enrolled in Medi-Cal and in good standing or are pending Medi-Cal enrollment and who have submitted a Family PACT application packet may complete the Provider Orientation to certify a site for enrollment.

Each service location must designate one eligible representative to be the site certifier. The site certifier cannot certify multiple sites.

The medical director, physician, nurse practitioner or certified nurse midwife who is responsible for overseeing the family planning services rendered at the location to be enrolled is eligible to certify the site.

Provider Orientation details and registration information is posted on the Family PACT website at www.familypact.org.

Upcoming In-Person Orientation

Los Angeles
June 28, 2018
8:30 a.m. – 12:30 p.m.
California Endowment
1000 North Alameda Street
Los Angeles, CA  90012

Please contact the Office of Family Planning by phone (916) 650-0414 or email us at ProviderServices@dhcs.ca.gov if you have any questions regarding the orientation process.

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8. July 2018 Medi-Cal Provider Seminar

The July Medi-Cal provider seminar is scheduled for July 17 – 18, 2018, at the Almansor Court in Alhambra, California. Providers can access a class schedule for the seminar by visiting the Provider Training web page of the Medi-Cal Learning Portal (MLP) and clicking the seminar date(s) they would like to attend. Providers may RSVP by logging in to the MLP.

Throughout the year, the Department of Health Care Services (DHCS) and the DHCS Fiscal Intermediary (FI) for Medi-Cal conduct Medi-Cal training seminars. These seminars, which target both novice and experienced providers and billing staff, cover the following topics:

Providers must register by July 3, 2018, to receive a hard copy of the Medi-Cal provider training workbooks on the date(s) of training. After July 3, 2018, the workbooks will be available only by download on the Medi-Cal Provider Training Workbooks page of the Medi-Cal website.

Note:

Wi-Fi will not be provided at the seminar. Please plan accordingly.

Providers that require more in-depth claim and billing information have the option to receive one-on-one claims assistance, which is available at all seminars, in the Claims Assistance Room.

Providers may also schedule a custom billing workshop. On the Lookup Regional Representative web page, enter the ZIP code for the area you wish to search and click the “Enter ZIP Code” button. The name of the designated field representative for your area will appear on the map. To contact a regional representative, providers must first contact the Telephone Service Center (TSC) at 1-800-541-5555 and request to be contacted by a representative.

Providers are encouraged to bookmark the Provider Training web page and refer to it often for current seminar information.

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9. A New Way to Subscribe – Contact Medi-Cal Subscription Service Representatives

Medi-Cal is committed to keeping you up-to-date on the latest Medi-Cal news and policy updates.

The Medi-Cal Subscription Service (MCSS) is a free service that provides subscribers with personalized email notifications for urgent, high-impact announcements and monthly news/policy updates as they post to the Medi-Cal website.

Providers can now contact MCSS representatives directly at MCSSCalifornia@conduent.com to subscribe and for assistance with managing subscriptions. Subscribing is simple and free!

If you have not yet subscribed to MCSS, Medi-Cal encourages you to utilize one of the following two methods to subscribe.

To subscribe by email:

  1. Download the linked MCSS Subscriber Form

  2. Enter your name, email address, ZIP code and subscriber type in the appropriate fields

  3. Customize your subscription by selecting subject areas for NewsFlash announcements, Medi-Cal Update bulletins and/or System Status Alerts

  4. Attach your completed form to an email and send to MCSSCalifornia@conduent.com

To subscribe online:

  1. Go to the MCSS Subscriber Form page on the Medi-Cal website

  2. Enter your email address and ZIP code, and select a subscriber type from the drop-down menu

  3. Customize your subscription by selecting subject areas for NewsFlash announcements, Medi-Cal Update bulletins and/or System Status Alerts

  4. Click “Subscribe Now” at the bottom of the page

After the form has been received, a welcome email will be sent to the provided email address. If you are unable to locate the welcome email in your inbox, check your junk email folder.

For more information about MCSS, visit the MCSS Help page.

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10. Get the Latest Medi-Cal News: Subscribe to MCSS Today

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The Medi-Cal Subscription Service (MCSS) is a free service that keeps you up-to-date on the latest Medi-Cal news. Subscribers receive subject-specific emails shortly after urgent announcements and other updates post on the Medi-Cal website.

Subscribing is simple and free!

  1. Go to the MCSS Subscriber Form

  2. Enter your email address and ZIP code and select a subscriber type

  3. Customize your subscription by selecting subject areas for NewsFlash announcements, Medi-Cal Update bulletins and/or System Status Alerts

After submitting the form, a welcome email will be sent to the provided email address. If you are unable to locate the welcome email in your inbox, check your junk email folder.

For more information about MCSS, please visit the MCSS Help page.

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