Temporary Extension of Claims Submission Deadline for LEA Providers

April 1, 2022

Due to a hold on the Data Match process used by Local Educational Agency (LEA) providers, LEA providers with outstanding claims for dates of service on or after September 1, 2020, through May 31, 2021, have until June 30, 2022, to submit the identified claims to Medi-Cal.

The Data Match process, which is utilized to determine recipient eligibility, was placed on hold in September 2021, and led to providers being unable to receive eligibility data for claims they were trying to submit. This affected the timely submission of claims for the months of September 2020 and beyond. The Data Match process is scheduled to be back online in March 2022, which will allow providers to receive eligibility information again. Therefore, for a brief amount of time, and only for select claims, the Department of Health Care Services (DHCS) is extending the 12-month submission deadline that LEA providers are required to adhere to.

Again, providers who have outstanding claims for dates of service on or after September 1, 2020, through May 31, 2021, may submit claims to Medi-Cal without any timeliness-related reimbursement cutbacks, until June 30, 2022. Providers who do not have claims for dates of service within this timeframe, must still adhere to the 12-month billing limit described in the Local Educational Agency (LEA) Billing and Reimbursement Overview section of the provider manual.

For additional Eligibility Data Match questions, providers can email LEA@dhcs.ca.gov.