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On Friday, October 8, 2010, Governor Schwarzenegger signed legislation to enact the 2010 State Budget. The Department of Health Care Services notified the Fiscal Intermediary to release all payable held claims and process all provider claims over the weekend.
All payable claims that were received by 12:00 Noon on Friday, October 8 were processed over the weekend. The State Controller's Office will be mailing the warrants on Thursday, October 14, with an Electronic Fund Transfer date of Monday, October 18.
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Effective July 1, 2010, the state of California did not have an approved budget for current fiscal year 2010-11. The fiscal intermediary, HP Enterprise Services, continues to adjudicate claims, and providers continue to be reimbursed pursuant to state law, as outlined in the online update July 9, 2010 entitled Fiscal Year 2010-11 State Budget Reimbursement Contingency.
During this period of no state budget, the following non-institutional provider types will continue to receive payment regardless of the status of the state budget for Medi-Cal services rendered to beneficiaries:
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AIDS Waiver Services |
Occupational Therapists |
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Audiologists |
Optometric Group |
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Care Coordinator |
Optometrists |
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Certified Acupuncturist |
Orthotists |
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Certified Nurse Midwife |
Out-of-State |
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Certified Pediatric & Family Nurse Practitioners |
Outpatient Heroin Detoxification Center |
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Chiropractors |
Pharmacies/Pharmacists |
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Christian Science Practitioner |
Physical Therapists |
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Clinical Nurse Specialist Crossover Provider Only |
Physicians |
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Dispensing Opticians |
Physicians Group |
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EPSDT Supplemental Services Providers |
Podiatrists |
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Group Certified Pediatric & Family Nurse Practitioners |
Portable X-Ray |
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Group Respiratory Care Practitioners |
Prosthetics |
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Health Access Program |
Psychologists |
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Hearing Aid Dispensers |
Respiratory Care Practitioner |
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Independent Diagnostic Testing Facility Crossover |
RVNs Individual Nurse |
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Nurse Anesthetists |
Speech Therapists |
During this period of no state budget, the following institutional provider types will continue to receive payment regardless of the status of the state budget for services rendered to Medi-Cal beneficiaries:
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Are your Medi-Cal payments being delayed due to patient eligibility?
Checking patient’s eligibility can make the difference in your reimbursement. Make sure your office staff is checking your patients Medi-Cal eligibility at each visit. Circumstances change all the time, your patient may be covered by Medi-Cal one month and the following month be covered by an HMO or Commercial Insurance, if eligibility is not verified you can risk your claim payment being delayed and/or reduced. To verify your patients eligibility simply log on to www.medi-cal.ca.gov or call the Automated Eligibility Verification System (AEVS) at 800-456-2387.
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Fiscal Year 2010-11 State Budget Reimbursement Contingency
Since the State of California did not enact the fiscal year 2010-11 budget by June 30, 2010, the Department of Health Care Services (DHCS) will direct the fiscal intermediary, HP Enterprise Services, to implement provisions pursuant to state law, to continue processing and adjudicating claims as outlined below.
HP Enterprise Services will process and adjudicate claims for the following programs, regardless of date of service: