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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:

AIDS Waiver Services

Occupational Therapists

Audiologists

Optometric Group

Care Coordinator

Optometrists

Certified Acupuncturist

Orthotists

Certified Nurse Midwife

Out-of-State

Certified Pediatric & Family Nurse Practitioners

Outpatient Heroin Detoxification Center

Chiropractors

Pharmacies/Pharmacists

Christian Science Practitioner

Physical Therapists

Clinical Nurse Specialist Crossover Provider Only

Physicians

Dispensing Opticians

Physicians Group

EPSDT Supplemental Services Providers

Podiatrists

Group Certified Pediatric & Family Nurse Practitioners

Portable X-Ray

Group Respiratory Care Practitioners

Prosthetics

Health Access Program

Psychologists

Hearing Aid Dispensers

Respiratory Care Practitioner

Independent Diagnostic Testing Facility Crossover

RVNs Individual Nurse

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:

Community Hospital Outpatient Department

Community Hospital Inpatient

County Hospital Inpatient

County Hospital Outpatient

Long-Term Care (LTC) Facility

Pediatric Subacute Care - LTC

The remaining institutional provider types will continue to receive payment for services rendered to Medi-Cal beneficiaries from the $2 billion Medical Providers Interim Payment (MPIP) fund until the 2010-11 budget is enacted or until the MPIP is exhausted. It is anticipated the MPIP fund will be exhausted with the August 19, 2010, warrant release date, which equates to an Electronic Fund Transfer (EFT) deposit date of August 23, 2010.

Providers serving the following programs will not receive reimbursement for services rendered in 2010-11 until the budget is enacted. They will continue to receive payment for services rendered in 2009-10, even though their claims were not submitted for payment until 2010-11.

  • Expanded Access to Primary Care Program (EAPC)
  • Cancer Detection Program: Every Woman Counts (CDP: EWC)

Providers that serve the following public health care programs will not be paid until the 2010-11 budget is enacted:

  • State-Only California Children’s Services (CCS)
  • State-Only Child Health and Disability Prevention (CHDP) program
    Genetically Handicapped Persons Program (GHPP)
    Healthy Famailies Program (HF) claims administered by the Department of Health Care Services (DHCS)