By Region 3 Representatives and contributing authors: Shanna Muirhead (WA), Program Manager, School-Based Health Care Services, Washington State Health Care Authority and Cathy Bennett, Medi-Cal Program Specialist, Sacramento City Unified School District

Electronic Signatures Allowed in Washington State

The School Based Health Care Services Program in Washington State recently started allowing school based providers to electronically sign daily treatment notes and service logs for direct health care services provided to children with IEPs and IFSPs. Since authenticating treatment notes with a handwritten signature can be very time consuming, the use of electronic records and electronic signatures can significantly reduce costs as well as simplify and speed up work processes. It is expected that acceptance of electronic signatures will relieve some of the administrative burden that can come with Medicaid billing. The State law authorizing Washington State agencies to utilize electronic signatures is codified in Chapter 19.360 RCW.

New Mexico in Final Stages, Transition to Cost Reporting and Settlement

The New Mexico Human Services Department’s Medical Assistance Division is in the final stages of negotiating a State Plan Amendment (SPA) with the Centers for Medicare and Medicaid Services (CMS). This SPA will transition the Medicaid School-Based Services (MSBS) direct service payments from the standard fee-for-service model to one that involves cost reporting and settlement for services. This change will start with services provided on or after July 1, 2015. The department’s School Health Office, which administers the MSBS, has been working with Fairbanks, LLC to implement the cost report. The state and Fairbanks have been co-administering the state’s current random moment time study (RMTS) and administrative claiming programs since 2011. In 2013, as the state prepared to re-procure the contract for the RMTS and administrative claiming, it was decided to add direct services cost reporting and settlement. According to School Health Manager Christie Guinn, “The agency felt comfortable with the current RMTS process and decided that making the transition to cost settlement was something we were ready to do. We anticipate this being a very positive change for our schools and are anxious to get final approval from CMS and begin the final stages of implementation.”

California Submission of State Plan Amendment

On September 30, 2015 California’s Department of Health Care Services (DHCS) submitted to the Centers for Medicare and Medicaid Services (CMS) and State Plan Amendment (SPA). This SPA will include new assessment and treatment services, new practitioner types, and a Random Moment Time Survey (RMTS) methodology to the LEA Medi-Cal Billing Option Program. In addition, DHCS is implementing the guidelines in accordance with the letter to the State Medicaid Director (SMD-14-006) dated December 15, 2014.

More information regarding the CA SPA and copies of CMS and DHCS communications to Request Additional Information (RAI) can be found by clicking here.