Agencies
Services
Provider Notice issued 04/03/03
Deferral of reimbursement payments for administrative outreach codes C1 and C2 and 75% reimbursement rate
| To: | Local Education Agencies (LEAs) |
| Date: | April 3, 2003 |
| Re: | Deferral of reimbursement payments for administrative outreach codes C1 and C2 and 75% reimbursement rate |
The Centers for Medicare and Medicaid Services (CMS) has notified the Department of its intent to defer administrative outreach claim amounts attributable to activities claimed as Code C1 (non-SPMP) and Code C2 (SPMP) for costs incurred in the October 1- December 31, 2002 quarter. This federal deferral action requires the Department to reduce claims for all LEAs that submitted a Code C1 or Code C2 claim for costs incurred in that quarter. Claims for LEAs that submit on a one-quarter delay will be similarly adjusted on the next administrative claim (April 15, 2003 submissions).
CMS has also declared its intent to reduce amounts claimed at the enhanced Federal matching rate of 75% for activities performed on or after January 1, 2003. Claimed amounts for Activity Codes E2 and F2 will be reimbursed at the 50% matching rate. The Department will adjust claims for this deferral.
The DPA is assessing the impact of the deferrals and is considering an appeal strategy. In the meantime, please continue to submit administrative claims in accordance with the current claiming methodology outlined in the Illinois Guide for School-Based Health Services Administrative Claiming. That is, continue to include claims for time and relevant expenditures attributable to activity codes C1, C2, E2, and F2.
Questions regarding this notice should be directed to School-Based Health Services at (217) 524-4976 or e-mailed to jaci.vaughn@illinois.gov
A. George Hovanec, Administrator
Division of Medical Programs