Sunday, December 17, 2017

OCMA Blog

Medi-Cal Requiring Re-Enrollment

The California Department of Health Care Services (DHCS) will soon be notifying physicians that they must re-enroll in Medi-Cal as one of the provisions of the Affordable Care Act (ACA). The ACA requires every state Medicaid program (Medi-Cal in California) to re-validate provider enrollment information at least every five years  beginning January 2, 2013.

DHCS is currently working to identify an initial list of all physicians and other providers who will be required to re-validate. Notices of re-validation will be mailed beginning the second week of January 2013. Notices will be sent to business location on file with DHCS. Each notice will include information on which application(s) must be completed. Anyone receiving a notice must complete and return the requested form(s) and required attachments within 35 working days of the date of the notice. Failure to do so may result in payment delays.

Physicians who have re-validated, updated or submitted new applications to the Medicare program within the last 12 months (January 1 through December 31, 2012) will not be required to re-validate at this time. However, your Medicare enrollment information must match the information on file with the Medi-Cal program. If it does not you will receive notice from DHCS requiring you to re-validate.

The California Medical Association (CMA) and DHCS have worked collaboratively over the past year to establish a phased, tightly-controlled re-enrollment process within the confines of current state and federal laws and regulations.

In addition, CMA will host two live webinar training courses with representatives from DHCS to walk attendees through the Medi-Cal enrollment process for both individual providers and groups. Also to be discussed will be program requirements and how to avoid common mistakes that can lead to delays, denials and exclusion from the Medi-Cal program. These extended-length webinars will be held November 15, 2012, and January 16, 2013, from 12:15 to 1:45 pm. These webinars are free and open to everyone.

OCMA/CMA members can contact the CMA reimbursement helpline: (888) 401-5911 or economicservices@cmanet.org


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