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)