Report 2014-130 Recommendation 18 Responses
Report 2014-130: California Department of Health Care Services: It Should Improve Its Administration and Oversight of School‑Based Medi-Cal Programs (Release Date: August 2015)
Recommendation #18 To: Health Care Services, Department of
To better maximize federal reimbursements for the administrative activities program, Health Care Services should, within six months, revise reimbursement rates to authorize claiming units to claim the 75 percent reimbursement rate for translation activities as federal law allows.
Annual Follow-Up Agency Response From September 2017
The new SMAA invoice that reflects 75% reimbursement for translation activities was approved by CMS on October 31, 2016 and was posted to the SMAA website on November 14, 2016
- Completion Date: November 2016
California State Auditor's Assessment of Annual Follow-Up Status: Fully Implemented
1-Year Agency Response
DHCS updated the SMAA invoice to include a 75% reimbursement rate for translation services. DHCS submitted the SMAA invoice with the SMAA manual to CMS on August 15, 2016, for their consideration. Upon CMS's approval, DHCS will implement the enhanced reimbursement.
- Estimated Completion Date: Awaiting CMS approval
- Response Date: September 2016
California State Auditor's Assessment of 1-Year Status: Partially Implemented
6-Month Agency Response
DHCS is working to implement the enhanced 75 percent reimbursement for translation services. DHCS has reached out to the Centers for Medicare and Medicaid Services (CMS) for further clarification and guidance on eligible time study participants and activities and is still awaiting a response. DHCS is also working on updating the SMAA invoice to allow claiming for the enhanced translation rate.
- Estimated Completion Date: April 2016
- Response Date: March 2016
California State Auditor's Assessment of 6-Month Status: Partially Implemented
In July 2016, Health Care Services told us that it will implement the enhanced 75 percent reimbursement rate for translation services with the revised random moment time survey invoice, and that the revised invoice is under final review. Health Care Services also stated that, once complete, the revised invoice will be sent to the federal Centers for Medicare and Medicaid Services for review and approval.
60-Day Agency Response
DHCS has reached out to stakeholders and received some feedback that the workload would not justify the additional time involved in tracking this activity and would outweigh the return on investment. However, DHCS is reviewing how other states are implementing to determine best practices to develop a process to claim translation services at the enhanced rate of 75 percent should stakeholders choose to claim this activity.
- Estimated Completion Date: December 2015
- Response Date: October 2015
California State Auditor's Assessment of 60-Day Status: Pending
Agency responses received are posted verbatim.