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HMDRF Recognition of Accreditation
As a result of CAMPS sponsored legislation, AB 1387 (Arambula), signed by the Governor a licensed HMDRF that is accredited will be exempt from routine inspection. Inspection would still be triggered by a complaint and any new applicant would be subject to initial inspection.
CDPH has posted revisions to the new and renewal application form that now includes a question on where the HMDRF is accredited, by whom and requests a copy of the accreditation certificate . Since renewal is annual they will establish which existing licensees are accredited and be able to exempt them from routine inspection
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Resubmission of Denied Medicare
Non-Covered Incontinence Supplies Claims
December 29, 2017
The Department of Health Care Services (DHCS) identified a claims processing issue affecting medical supplies claims billed with incontinence wash HCPCS code A4335 (incontinence supply; miscellaneous) and incontinence cream/ointment HCPCS code A6250 (skin sealants, protectants, moisturizers, ointments, any type, any size).
Providers may resubmit claims that meet all of the following criteria:
- Claims for dual-eligible beneficiaries that were denied with Remittance Advice Details (RAD) code 0012: Medi-Cal benefits cannot be paid without proof of payment/description of the denial from Medicare and that were for supplies dispensed for a Medicare non-covered treatment
- Claims containing either HCPCS code A4335 or A6250
- Claims denied on or after November 21, 2016
Providers may resubmit claims adhering to the criteria above through June 28, 2018.
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One Capitol Mall, Suite 800
Sacramento, CA 95814
t: (916) 443-2115
f: (916) 444-7462
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