Cost and Reimbursement Comparison Schedule for FY 2014-15
August 1, 2016
Submission Deadline
The submission deadline for the Cost and Reimbursement Comparison Schedule (CRCS) for Fiscal Year 2014-15 is
November 30, 2016.
Mandatory CRCS Requirement:
Participants in the LEA Medi-Cal Billing Option (LEA BOP) are required to annually certify, through the CRCS process, that the public funds expended to provide LEA BOP services are eligible for federal financial participation. Therefore, continued enrollment in the LEA BOP is contingent upon timely submission of the CRCS each fiscal year. Failure to meet this requirement may result in suspension from the LEA BOP.
LEA Annual Reimbursement Report:
Note: The LEA Annual Reimbursement Report will assist LEAs to complete CRCS Worksheets A-4 and B-4. LEAs should verify the reasonableness between your internal accounting system and the LEA Annual Reimbursement Report and accurately input encounters, units and reimbursement information for each procedure code/modifier combination on your CRCS form. Potential discrepancies between the LEA Annual Reimbursement Report and your internal system numbers should be documented to support the numbers you input on the CRCS forms and to provide an accounting documentation trail for review and audit.
FY 2014-15 CRCS and Certification of Zero Reimbursement Forms:
FY 2014-15 CRCS Forms (Archived)
FY 2014-15 CRCS Forms - ADA Compliant (Archived)
FY 2014-15 CRCS Instructions (Archived)
FY 2014-15 Certification of Zero Reimbursements (Archived)
LEAs that did not receive any Medi-Cal reimbursement
in the
LEA Medi-Cal Billing Option Program for
services that were provided in State Fiscal Year 2014-15
must submit the "Certification of Zero Reimbursement for LEA Services" DHCS Form 2437a,
and
are not required to submit the CRCS Form 2437.
Submit the Zero Reimbursement Form by November 30, 2016 to
LEA.CRCS.Submission@dhcs.ca.gov and use the following naming convention:
Fiscal Year.NPI Number.Business LEA Name.Submission Date.ZERO CRCS
Example: FY1314.9726458910.CaliforniaSchoolDistrict.11.21.2015.ZERO CRCS.PDF
Additional CRCS Resources:
LEA Reimbursement Rates:
-
FY 2015-16 No Rate Change: See FY 2014-15 Inflated Reimbursement Rates (Archived)
Required Documentation:
DHCS Audits and Investigations (A&I) staff will conduct a desk or field audit of the CRCS to determine the final settlement amount. Supporting documents must be maintained by each LEA for a minimum of three years from the date of final submission of the CRCS. These documents must be verifiable by A&I. LEA providers may appeal the determinations made by DHCS pursuant to
Welfare and Institutions Code, Section 14171.
CRCS Submission Process:
Excel version of the completed CRCS form (all worksheets)
Scanned version of the original signed CRCS form (i.e., PDF, JPEG, etc.)
CRCS electronic files and the subject line of the email must follow this naming convention: Fiscal Year,
NPI Number,
Business LEA
Name,
Submission Date
- CRCS Fiscal Year Example: FY1415.1234567890.SampleSchoolDistrict.10.15.2016.CRCS.XLS (or .PDF)
LEAs are required to maintain the original hard copy CRCS with all worksheets and the Certification page signed in blue ink on site for DHCS A&I audit purposes, if necessary.
Audit Review and Analysis Section (ARAS) of A&I
is implementing a 100% reimbursement withhold on providers who are more than 30 days past the due date of the CRCS. The 100% withhold will be lifted once the delinquent CRCS has been submitted and has passed the acceptance review.
CRCS Questions/Contacts:
