DHCS/MediCal: Provider Payments During Period Without State Budget

If the State of California does not enact the Fiscal Year 2008-09 budget by June 30, 2008, the Department of Health Care Services (DHCS) will direct the fiscal intermediary (EDS) to continue to pay to Medi-Cal practitioners per federal mandate and continue to pay Medi-Cal institutional providers through the Medical Providers Interim Payment (MPIP) fund until the loan is exhausted by the anticipated date of July 17, 2008. After that date, Medi-Cal institutional providers will not receive payment until a budget is enacted, as DHCS has no authority to do so.

After the MPIP Fund is exhausted in approximately mid-July (please check the Medi-Cal website for Budget information concerning the MPIP Fund), institutional providers can expect to begin receiving Value of Claim (VOC) letters. Through the new automated VOC process, all Medi-Cal providers whose held payments equal or exceed $5,000.00 will be automatically sent a VOC letter on a weekly basis. This letter will be based on the amount approved for payment (often referred to as the “In Process” amount) each Monday and will be cumulative each week. The letter will also inform providers for which programs payments are owed and how much is owed by program (Healthy Families, Medi-Cal, etc.). This letter will be sent to the “Pay-To” address on file. Providers who have not updated their “Pay-To” address with Provider Enrollment Division (via a Medi-Cal Supplemental Changes DHCS 6209 form, revised 2/08), may not receive this letter. Providers who want this letter but have not received it and have a correct Pay-To address on the Provider Master File, can contact the Telephone Service Center (TSC) after the MPIP loan is exhausted at 1-800-541-5555 and choose option 15, and then option 13.