​​​​​​​​​​​​LEA Medi-Cal Billing Option Program FY 2009/10 CRCS Resubmission​

DHCS Safety Net Financing (SNF) and Audits and Investigations (A&I) reviewed the FY 2009/10 CRCS instructions and reporting requirements and identified two reporting issues.   DHCS is allowing LEAs the option of resubmitting the FY 2009/10 CRCS with updated reporting requirements and clarified instructions (as detailed below).  LEAs are not required to resubmit their FY 2009/10 CRCS report to DHCS.  If your LEA determines that the reporting differences related to the following two issues are significant to your LEA’s net overpayment/underpayment, you have the opportunity to resubmit your CRCS by November 30, 2012.  Otherwise, A&I will accept your LEA’s original submitted FY 2009/10 CRCS.  Regardless of whether or not your LEA opts to resubmit a FY 2009/10 CRCS, all LEAs must maintain supporting documentation for the information reported on the CRCS form for at least three years from the date of CRCS submission/resubmission for State and/or federal review and audit. 

​Issue #1 - Federally Funded FTEs and Hours

The FY 2009/10 CRCS excluded federal revenues from LEA practitioner expenditures reported on Worksheets A.1/B.1 and A-1/B-1; however LEAs were instructed to report all practitioner FTEs and hours (regardless of whether or not they were federally funded) on Worksheet A-3/B-3.  The CRCS removed federal revenues, but included federally funded practitioners which diluted the percentage of time estimates for practitioners and understated costs on the CRCS, if the LEA reported federally funded expenditures and FTEs.              

FY 2009/10 CRCS Resubmission Reporting Requirement

On Worksheet A-3/B-3, report federally funded FTEs (or portion of FTEs) if their time is not dedicated to the federal program.  Do not report federally funded FTEs (or portion of FTEs) if their time is dedicated to the federal program.  Note that Resource Code 5640 (Medi-Cal Billing Option) is not considered to be restricted federal funds.  Since Resource Code 5640 funding is not considered to be “Federal Revenues”, these funds should not be reported on Worksheet A.1/B.1, Column D in the CRCS.  LEAs may include allowable expenses (i.e., practitioner salaries, benefits, etc.) funded with Resource Code 5640 in the CRCS. 

Consider Resubmitting If:  

1. Your LEA received federal revenues and reported all federally funded FTEs and hours (regardless of whether they were dedicated to the federal program) on your FY 2009/10 CRCS
2. You determine that reporting only federally funded FTEs (or portion of FTEs) if their time is not dedicated to the federal program will have a significant impact on your LEA’s net overpayment/underpayment

Issue #2 – “All Qualified” Practitioners

The FY 2009/10 CRCS instructions specified that LEAs were to report “all qualified practitioners employed by the LEA, regardless of whether or not they provided LEA services to Medi-Cal beneficiaries.​”  This meant that the LEA should have included all costs and hours for practitioners that were qualified to provide LEA services, regardless of whether or not they rendered services and billed for Medi-Cal beneficiaries.  However, the definition of “all qualified” was subject to interpretation.  For example, an LEA may or may not have included a credentialed speech-language pathologist who has the required credential (making them qualified), but the LEA does not have a licensed speech-language pathologist to supervise the practitioner (therefore, the practitioner cannot bill Medi-Cal).  A list of qualified LEA practitioners and their required qualifications can be found in the LEA Provider manual (section loc ed rend).

FY 2009/10 CRCS Resubmission Reporting Requirement

Report expenditures, FTEs and hours for all qualified district employed practitioners billing LEA reimbursable services in the LEA Medi-Cal Billing Option Program.  LEAs must be able to validate required practitioner licenses and/or credentials.  In the prior example, an LEA would not include the expenditures, FTEs and hours for a credentialed speech-language pathologist who has the required credential, but the LEA does not have a licensed speech-language pathologist to supervise the speech-language pathologist.  That credentialed speech-language pathologist is not qualified to bill LEA reimbursable services in the LEA Medi-Cal Billing Option Program. 
​
​Consider Resubmitting If:

1. Your LEA may have reported inaccurate “all qualified” practitioners expenditures, FTEs and hours
2. You determine that reporting only qualified billable practitioners billing LEA reimbursable services in the LEA Billing Option Program will  have a significant impact on your LEA’s net overpayment/underpayment
   

Process for Resubmitting FY 2009/10 CRCS – Due by November 30, 2012

1. Download the updated FY 2009/10 CRCS (version 4/12)​
2. Complete the FY 2009/10 CRCS (version 4/12) form based on the updated reporting requirements to resolve the federally funded and “all qualified” practitioner issues.  Note that updated instructions on the FY 2009/10 CRCS (version 4/12) form are bolded, italicized and underlined.
3. Save the FY 2009/10 CRCS form in the following file naming convention:

• ​ Fiscal Year
• ​Example: FY0910
• ​National Provider Identifier (NPI) number
• ​Example: 1234567890
• ​Business LEA Name
• Example: BusinessLEA Name
• Resubmission Date (MM.DD.YYYY) format.  This date should be the date you are submitting your CRCS to DHCS.
• ​Example: 11.15.2012
• CRCS Resubmission” to identify the electronic file is a resubmission
• Example: CRCSResubmission
• Full file naming convention see  following example:
• ​FY0910.1234567890.BusinessLEAName.11.15.2012 .CRCSResubmission.xls
  

Note that each piece of information included is separated by a period and no spaces are between words (i.e., BusinessLEAName)

4. Submit the following electronic files no later than November 30, 2012 to LEA.CRCS.Submission@dhcs.ca.gov

• Excel version of the completed CRCS resubmission form (all worksheets)
• Scanned version of the original signed completed CRCS resubmission form (i.e., PDF, JPEG, etc.)

Questions​

CRCS Submission Questions: Email LEA.CRCS.Submission@dhcs.ca.gov
CRCS Questions: Email LEA.CRCS.Questions@dhcs.ca.gov​
General LEA Program Questions: Email LEA@dhcs.ca.gov ​