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Fiscal Year 2016 – 2017 State Budget Reimbursement Contingency

June 14, 2016

If the State of California does not enact the 2016 – 2017 Fiscal Year (FY) budget by June 30, 2016, the Department of Health Care Services (DHCS) will direct Xerox State Healthcare, LLC (Xerox) to implement provisions pursuant to state law to continue processing and adjudicating claims as outlined below.

Xerox will process and adjudicate claims for the following, regardless of dates of service:

  • Abortion
  • California Children’s Services (CCS)/Medi-Cal
  • Child Health and Disability Prevention Program (CHDP)/Medi-Cal
  • Family Planning, Access, Care and Treatment (Family PACT) Program
  • Medi-Cal

Xerox will withhold all reimbursements for the following programs, regardless of dates of service. The last warrant date for claims for these programs will be June 23, 2016:

  • CCS-only (aid code 9D)
  • CHDP-only (aid code 8Y)
  • Healthy Families
  • Genetically Handicapped Persons Program (GHPP) (aid code 9J)

Effective on dates of service on or after July 1, 2016 claims submitted by the Every Woman (EWC) program, for which contingency funding is not available, will continue to be processed. Reimbursement for these claims will be withheld until the state budget is approved and Xerox receives approval from the State to resume reimbursement. Claims will continue to be reimbursed for dates of service prior to July 1, 2016.

All providers are asked to continue to render services and submit claims for processing.