Family PACT


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ANNOUNCEMENTS

  Breast and Cervical Cancer Treatment Program (BCCTP)

Family PACT providers have the opportunity to enroll clients directly into BCCTP for services beyond the scope of Family PACT.  The BCCTP provides Medi-Cal benefits for the treatment of breast and cervical cancer.  Family PACT providers are reminded that:

  • Clients who are enrolled in BCCTP by Family PACT providers, including courtesy enrollments, must pass the FPACT eligibility screening criteria.  BCCTP does not have age or other insurance restrictions, but the person must still meet the following criteria: 1) the client must have a total taxable family income at or below 200 percent of the Federal Poverty Level, 2) the client must be a California resident, and 3) the client must be diagnosed with, and need treatment for, a qualifying cancer diagnosis.

  • Never repeat a BCCTP enrollment if there are mistakes/typos or if the confirmation was not what the provider expected.  Please contact BCCTP via email at BCCTP@dhcs.ca.gov with any corrections and/or questions regarding the application.  BCCTP program managers are available to address any questions and/or corrections.

 Click here for Breast and Cervical Cancer Treatment Program (BCCTP) Questions and Answers

 

Upcoming EPC for Intrauterine Contraceptive System Claim Denials

Reimbursement rates for HCPCS codes J7297 (levonorgestrel-releasing intrauterine contraceptive system, 52 mg, 3 year duration) and J7298 (levonorgestrel-releasing intrauterine contraceptive system, 52 mg, 5 year duration) are scheduled to implement the first quarter of 2017. An Erroneous Payment Correction (EPC) will be issued for claim denials under Remittance Advice Details (RAD) codes 9702: This procedure code is not payable without an invoice and 0188: This is a “By Report” procedure. No report is attached or the attached report is insufficient to warrant payment. The EPC will be effective for dates of service on or after October 1, 2016, to the implementation date of the reimbursement rates.

Pending the EPC’s release, providers may choose to resubmit denied claims under RAD codes 9702 and 0188 with appropriate attachments.

       

Implementation Delayed for Family PACT Benefit, CPT-4 Code 87806

An article published in the October 2016 Family PACT Update titled Family PACT Adds CPT-4 Code 87806 HIV Screening Code as a Benefit informed providers that the new benefit is effective for dates of service on or after November 1, 2016. However, a NewsFlash article published on October 14, 2016, titled Delay Update: CLIA-Waived Benefit for HIV-1 and HIV-2 Testing Code notified providers that the related Medi-Cal policy implementation will be delayed until at least the end of 2016. An Erroneous Payment Correction will be initiated to reprocess affected Family PACT claims. Providers should continue to submit claims timely.

Information Related to Insurance Affordability Programs
An informational video for providers

Notice to Family Planning, Access, Care and Treatment (Family PACT) Providers and Partners  

Section 1557 is the nondiscrimination provision of the Affordable Care Act (ACA).  Section 1557 has been in effect since 2010 and prohibits discrimination on the basis of race, color, national origin, sex (age, or disability in certain health programs or activities with the intent of eliminating barriers to access to health care.    Section 1557 builds on the following long-standing Federal civil rights laws: Title VI of the Civil Rights Act of 1964 (Title VI), Title IX of the Education Amendments of 1972 (Title IX), Section 504 of the Rehabilitation Act of 1973 (Section 504), and the Age Discrimination Act of 1975 (Age Act).  On May 13, 2016, the United States Health and Human Services (HHS) Office for Civil Rights issued its final rule implementing Section 1557.  The rule applies to any health program or activity, any part of which receives federal financial assistance, an entity established under Title I of the ACA that administers a health program or activity, and HHS.  The rule, in part, includes new requirements for covered entities to provide language assistance to limited English proficient individuals.  To learn more about the application of the final rule implementing Section 1557 to you and your entity, and the requirements under the rule, DHCS encourages you to reach out to your representative professional organizations, or visit HHS’s Section 1557 webpage to learn more, find sample materials, and review other resources available at: http://www.hhs.gov/civil-rights/for-individuals/section-1557/index.html.      

       

ICD-10 2017 Updates for Contraceptive-Related Services
A bulletin article was published on August 31, 2016 to inform providers of the Centers for Medicare & Medicaid Services (CMS) 2017 annual ICD-10-CM updates:  http://files.medi-cal.ca.gov/pubsdoco/newsroom/newsroom_25088.asp.  Providers are required to use the new ICD-10 codes as of 10/1/16.  The system will be updated by this time to accept the new codes submitted on claims, and provider manual updates are in progress.  The Medi-Cal manual updates will publish together with the Family PACT manual updates.

Under Medi-Cal, claims submitted using the new 2017 ICD-10 family planning codes will be processed as the codes are available.  For Family PACT, the table will not be updated in time for the 10/1/16 effective date.  Claims for J7303 (vaginal ring),  J7304 (transdermal patch), and 57170 (diaphragm or cervical cap fitting) submitted with the ICD-10-CM for surveillance encounters may be impacted and claims may deny. Providers are expected to submit claims timely.

An Erroneous Payment Correction (EPC) will be put in place to cover any erroneous denials for FPACT claims between October 1, 2016 and implementation date of the table update.          

  ZIKA and Family Planning

The consequences of Zika are reduced by educating and counselling clients about transmission of the virus and the risks it poses to reproductive health.  Family PACT/Medi-Cal providers should engage clients, through counseling at every encounter, about the risks of the Zika virus, especially with respect to travel, before planning a pregnancy and to provide access to contraceptives, including long acting reversible contraceptives, for women who wish to avoid or delay a pregnancy. 

For more information, please visit the California Department of Public Health Zika page. Zika Toolkit

Live course on Zika: Preconception & Perinatal Recommendations for Health Care Providers
More information and registration...

   ACA Requirements for ORP Providers Available on ORP Web Page 
Read more.....        

   February 2017 Family PACT Update

  • Get the Latest Medi-Cal News: Subscribe to MCSS Today
  • Update: DHCS Fiscal Intermediary Name Change
  • Reminder: Paper Claim Submission Guidelines
  • Provider Orientation
  • March 2017 Medi-Cal Provider Seminar
  • FAME File Records Updated to Allow for New Expected Date of Delivery
  • Provider Manual Revisions         

  MEDI-CAL SUBSCRIPTION SERVICES(MCSS)

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  VISIT THE WELLTOPIA WEBSITE

Welltopia connects Californians, especially those with limited incomes, with credible resources for healthy personal, family and community development, starting with topics that address the leading causes of preventable mortality and the social determinants of health.  Welltopia includes a wide-range of resources, on topics including nutrition, physical activity, smoking cessation, alcohol and drug abuse prevention, stress management, health insurance, residency, and social services, among others. Resources include other websites, directories, videos, photos, graphics, and applications.

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