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Health and Human Services Agency (HHSA) recommending the Board consider approving and authorizing the Chair to sign a letter to the California Department of Finance in support of the California Behavioral Health Directors Association (CBHDA) and the California State Association of Counties (CSAC) action requesting forgiveness of the pending California Department of Health Care Services (DHCS) recoupment for $1,712,033 in Medi-Cal behavioral health services claims.
FUNDING: 1991 Behavioral Health Realignment.
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DISCUSSION / BACKGROUND:
On January 27, 2022, the Health and Human Services Agency (HHSA) was notified by the California Department of Health Care Services (DHCS) of a pending recoupment for Medi-Cal behavioral health services claim. The DHCS consolidated recoupment for HHSA is estimated at $1,712,033 and is inclusive of the following three (3) categories:
1. 2018 United States Department of Health and Human Services Office of Inspector General (OIG) Audit - $354,348: In a report released August 2018 as a result of the OIG audit of DHCS, the OIG identified $180.7 million due from California counties to the federal government for unallowable Medicaid reimbursements for Specialty Mental Health Services. During 2019, DHCS had initially recouped one-quarter (1/4) of this repayment amount from counties by offsetting county 1991 Realignment funds and agreed to defer offsets in 2020 and 2021 as the Realignment revenues were determined to be too low to cover the amounts due. El Dorado County was identified to be responsible for $354,348. DHCS proposes to resume recoupments in Fiscal Year (FY) 2022-23.
2. State-Only Claiming Error for Medi-Cal Beneficiaries with Unsatisfactory Immigration Status (UIS) receiving Specialty Mental Health Services (SMHS) and Drug Medi-Cal (DMC) - $26,132: As a result of a United States Centers for Medicare and Medicaid Services (CMS) Financial Management Review of DHCS for Medi-Cal Beneficiaries with UIS, DHCS identifi...
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