Medi-Cal Update

Psychological Services | October 2019 | Bulletin 529

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1. Drug Onasemnogene Abeparvovec-xioi Requires Own SAR

Effective for dates of service on or after May 1, 2019, the drug onasemnogene abeparvovec-xioi is excluded from any California Children’s Services and Genetically Handicapped Persons Program (GHPP) Service Code Grouping (SCG). Therefore, providers must submit a separate Service Authorization Request (SAR) for the drug.

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

Provider Manual(s) Page(s) Updated
Audiology and Hearing Aids
Chronic Dialysis Clinics
Clinics and Hospitals
Durable Medical Equipment
General Medicine
Home Health Agencies/Home and Community-Based Services
Inpatient Services
Local Educational Agency
Medical Transportation
Obstetrics
Orthotics and Prosthetics
Pharmacy
Psychological Services
Rehabilitation Clinics
Therapies
Vision Care
cal child sar (7, 8); genetic (11)
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2. Hospice Recipients are Eligible for End of Life Option Act Services

Medi-Cal would like to clarify that beneficiaries who have elected to receive hospice care are also eligible for End of Life Options Act services, including aid-in-dying drugs and medical services related to prescribing these drugs.

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

Provider Manual(s) Page(s) Updated
Clinics and Hospitals
General Medicine
eloa (2); hospic (11)
Hospice Care Programs
Inpatient Services
hospic (11)
Pharmacy
Psychological Services
eloa (2)
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3. ESRD Pilot Project Extended for VillageHealth

The End Stage Renal Disease (ESRD) Pilot Project for VillageHealth has been extended through December 31, 2020. All existing billing instructions remain the same and are applicable to the participating provider.

The ESRD Pilot Project was established to accept and process claims for participating providers who meet the criteria for Medi-Cal secondary payments. This allows for payment of coinsurance and deductibles for dual-eligible recipients in a Medicare Advantage plan. VillageHealth is the only Medicare Advantage plan for which its providers meet the criteria for Medi-Cal secondary payments.

An Erroneous Payment Correction (EPC) will be implemented to reprocess affected claims.

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

Provider Manual(s) Page(s) Updated
Acupuncture
Adult Day Health Care Centers
AIDS Waiver Program
Audiology and Hearing Aids
Chiropractic
Durable Medical Equipment
Expanded Access to Primary Care Program
Heroin Detoxification
Home Health Agencies/Home and Community-Based Services
Hospice Care Program
Inpatient Services
Local Educational Agency
Medical Transportation
Multipurpose Senior Services Program
Obstetrics
Orthotics and Prosthetics
Pharmacy
Psychological Services
Rehabilitation Clinics
Therapies
Vision Care
oth hlth (1)
Chronic Dialysis Clinics
Clinics and Hospitals
General Medicine
dial end (5); oth hlth (1)
Part 1 mcp spec (7); medicare (3)
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4. Medi-Cal Celebrates Medi-Cal Subscription Service Milestone Achievement

The Department of Health Care Services (DHCS) is excited to announce that its Medi-Cal Subscription Service (MCSS) reached and surpassed 20,000 total subscribers as of September 2019.

DHCS first launched its new MCSS in December of 2012, and since that launch, it has witnessed steady growth each year in the volumes of providers and stakeholders who have joined up and officially subscribed to this free and tailored information-based notification service.

Since launching in 2012, DHCS has marketed its MCSS via informational flyers, online articles and at annual Provider Training Seminars throughout California. It’s at these seminars where MCSS representatives directly informed and assisted providers in signing up for the MCSS at the MCSS information booth.

DHCS has received an impressive array of positive and encouraging feedback from countless providers about the MCSS including their individual and satisfied experiences with this service each year.

The MCSS offers an array of provider communication notifications that subscribers can choose to receive including NewsFlash articles, Medi-Cal Update Bulletins and System Status Alerts (SSAs). In addition, each subscriber is able to tailor their individual MCSS experience by selecting only the provider communications and subject matters that interest them and pertain to their Medi-Cal business.

MCSS is a terrific way for providers and stakeholders to save time and ensure that they never miss important program updates and policy changes. The MCSS notifies subscribers the same day whenever the Medi-Cal program releases articles, bulletins and SSAs on the Medi-Cal website.

Providers who have not yet subscribed to the MCSS are encouraged to join this growing community of more than 20,000 subscribers and take full advantage of this free informational service. DHCS invites providers and other interested parties to subscribe today by completing the MCSS Subscriber Form located online.

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

MCSS Logo

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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6. Provider Manual Revisions

Pages updated due to ongoing provider manual revisions:

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