2007 - 2008 State Budget Reimbursement Contingency
If the state of California does not enact the fiscal year
2007– 2008 budget by June 30, 2007, the California Department of
Health Services (DHCS) will direct the Fiscal Intermediary, EDS,
to implement provisions pursuant to state law to continue
processing and adjudicating claims as outlined below.
EDS will process and adjudicate claims for the following
programs, regardless of date of service.
- Medi-Cal
- Family PACT (Planning, Access, Care and Treatment)
- California Children’s Services (CCS)/Medi-Cal
- Child Health and Disability Prevention (CHDP)/Medi-Cal
- Abortion
EDS 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 21, 2007.
- CCS-only
- Genetically Handicapped Persons Program (GHPP)
- Healthy Families (HF)
- CHDP-only (that is, claims for clients with aid code 8Y)
Effective for dates of service on or after July 1, 2007, claims submitted by provider types for which contingency funding is not available will continue to be processed, but reimbursement for these claims will be withheld until the state budget is approved and EDS receives approval from the state to resume reimbursement. (Claims will continue to pay for dates of service prior to July 1, 2007.) The following programs will be affected by the temporary withhold:
- Expanded Access to Primary Care Programs (EAPC)
- Cancer Detection Programs: Every Woman Counts (CDP:EWC)
- Children’s Treatment Program (CTP)
All providers are asked to continue to render services and submit claims for processing.