Medi-Cal Update

++An article titled “Medi-Cal Subscription Service (MCSS) is Live” is now posted to the News Flash area of the Part 1 Provider Communications section of the Medi-Cal website. Refer to this article for the most recent status of and instruction regarding MCSS.

Overview

The Department of Health Care Services (DHCS) is pleased to announce that the Medi-Cal Subscription Service (MCSS) is returning.

For providers and Medi-Cal stakeholders unfamiliar with the service, MCSS is a free service that sends subscribers subject-specific emails based on the provider communities they have subscribed to. This keeps subscribers up-to-date when urgent announcements and other updates post to the Medi-Cal Providers website.

DHCS took the service down in October 2021 to address some necessary changes. The returning MCSS retains the functionality and look-and-feel of the service subscribers are familiar with. However, DHCS wishes to highlight one change and one action required of subscribers to ensure they receive MCSS emails once the service is turned back on:

• Sent From Email Changed: Emails received via MCSS will be sent from the following email address: do-not-reply_MCSSCalifornia@gainwelltechnologies.com.


• Subscriber Action: The first few messages from MCSS may appear in spam or promotional inboxes. To avoid this, and to ensure they receive the latest messages from Medi-Cal fee-for-service, subscribers are instructed to add do-not-reply_MCSSCalifornia@gainwelltechnologies.com to their list of approved senders. Note that the exact instructions on how to add an email to the list of approved senders, will change depending on the email client in use. Medi-Cal has identified some frequently used email domains and resources on how to manage an approved senders list:


• Yahoo – Manage Spam and Mailing Lists in Yahoo Mail


• Google (Gmail) – Customize spam filter settings in Google Workspace


• AOL/Verizon – Manage spam and privacy in AOL Mail


• Hotmail - Block or allow (junk email settings)


• Subscribers who have alternative email domains not listed above (for example, @companyname.com), should defer to their company’s IT group or the email provider they use for their business, to ensure MCSSCalifornia@gainwelltechnologies.com is listed as an approved sender.


• Without taking action to add MCSSCalifornia@gainwelltechnologies.com to the list of approved senders, it is possible that MCSS messages will either be blocked from the subscriber’s account or be filtered into Spam/Promotional folders.

Returning MCSS Subscribers

DHCS recommends existing subscribers add do-not-reply_MCSSCalifornia@gainwelltechnologies.com to their approved sender list to resume receiving MCSS emails. This is the only action needed. You do not need to re-subscribe for MCSS. Subscribers should keep an eye out for a “Welcome Back” email in the near future to see if they have appropriately added do-not-reply_MCSSCalifornia@gainwelltechnologies.com to the approved senders list.

DHCS will not send MCSS emails for publications published between October 2021 and May 2022. Instead, the “Welcome Back” email will highlight major changes and point to additional resources on any missed updates. Medi-Cal apologizes for any inconvenience this may cause.

Existing Subscribers can update their subscription preferences through a link in the footer of MCSS emails they receive. Only the most recent MCSS email will properly update subscription preferences.

New MCSS Subscribers

New subscribers can either sign up now using the current MCSS Subscription Form, or when MCSS returns using the updated online form. New subscribers using the current MCSS Subscription Form will not receive any emails until MCSS returns and the “Welcome Back” email is sent. New subscribers who sign up when MCSS returns will receive a “Welcome to MCSS” email. New subscribers should add do-not-reply_MCSSCalifornia@gainwelltechnologies.com to their approved senders list.

What’s Next

A News article will be published on the Medi-Cal Providers website once MCSS and MLP surveys are officially brought back online, and the “Welcome Back” emails begin to be sent out. DHCS is projecting that this will occur in late May or early June 2022.

Additionally, for all MCSS subscribers, refer to the updated Med-Cal Subscription Service (MCSS) Help page to find more information about this service.

As previously announced in the article titled “Multiple NCCI Modifiers Now Billable Together,” multiple National Correct Coding Initiative (NCCI) modifiers may be billed on the same claim line if it is appropriate and medically justified. In particular, claims may have more than one NCCI associated modifier applied to a claim line only when medically necessary, as documented in the medical record, and in accordance with the Medicaid NCCI program and HCPCS and CPT^® guidelines for the modifier and procedure code combination. Providers can refer to Correct Coding Initiative: National section in the appropriate Part 2 manual for instructions regarding the appropriate use of NCCI-associated modifiers.

The Correct Coding Initiative: National manual section also includes direction specifically on how providers should complete claims to bypass any potential NCCI edit when they:

• Perform the same service on the same date for a newborn and the mother or;


• Perform the same service on the same day for newborns in a multiple birth scenario.

Additionally, the following resource list from the Centers for Medicare & Medicaid Services (CMS) Medicaid NCCI website have been added to the NCCI web page:

• NCCI Policy Manual for Medicaid Services


• The Medicare Learning Network (MLN) booklet, “How to Use the Medicaid National Correct Coding Initiative (NCCI) Tools”


• Complete Medicaid NCCI Edit Files


• Medicaid Change Reports


• Proper Use of Modifiers 59 & - X{EPSU}


• Medicaid NCCI Correspondence Language Manual


• Medicaid NCCI FAQs

Effective for dates of service on or after October 1, 2020, the California State Plan Amendment (SPA) 20-0035 updates the Medi-Cal prescriber requirements for medical supplies and incontinence supplies.

Claims for covered medical and incontinence supplies provided upon a prescription are eligible for reimbursement if the prescription is written by a physician, nurse practitioner (NP), clinical nurse specialist (CNS) or a physician assistant (PA) within their scope of practice. Code of Federal Regulations (CFR) Title 42, Section 440.70, requires Medicaid programs to only reimburse providers for medical and incontinence supplies written by a physician, MP, CNS or PA.

In addition to the policy changes, the following spreadsheets are retired from the Medi-Cal website and are available on the Medi-Cal Rx website:

• List of Contracted Diabetic Test Strips and Lancets


• List of Contracted Pen Needles


• List of Contracted Sterile Needles

The Medical Supplies and Incontinence sections of the provider manual have been updated to clarify the prescriber requirements.

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.

Pages updated due to ongoing provider manual revisions: