ACEs Screening Program Integrity

June 30, 2020

Eligible Medi-Cal providers who screen Medi-Cal patients for Adverse Childhood Experiences (ACEs) using a qualified screening tool can receive payment beginning on January 1, 2020. As of July 1, 2020, eligible Medi-Cal providers must have taken a certified training and self-attested to completing the training using their individual National Provider Identifier (NPI) in order to receive Medi-Cal reimbursement for ACEs screenings.

To be eligible for the payment, providers must document all of the following: the tool that was used; that the completed screen was reviewed; the results of the screen; the interpretation of results; what was discussed with the member and/or family; and any appropriate actions taken. This documentation must remain in the member’s medical record and be available upon request. When Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), Cost-Based Reimbursement Clinic (CBRC), Indian Health Services – Memorandum of Agreement (IHS-MOA) 638 Clinics and other provider groups submit a claim for a qualified ACE screening, clinics are responsible for ensuring that the rendering provider has completed and attested to completing a certified ACEs training.

As stated in the All Plan Letter 19-018: Proposition 56 Directed Payments for Adverse Childhood Experiences Screening Services, Managed Care Plans (MCPs), or their delegated entities, are responsible for ensuring their delegates comply with all applicable state and federal laws and regulations, contract requirements and other DHCS guidance. MCPs will have access to the list of providers that have self-attested to completing a certified ACEs training.