Medi-Cal Reimbursement and Compliance Programs

About Our Office

 

Sherry L. Purcell, Ph.D.,
Coordinator
Medi-Cal Reimbursement
and Compliance Programs
333 S. Beaudry Ave.
29th Floor
Los Angeles, CA 90017
213-241-0551 Phone
213-241-3314 Fax
sherry.purcell@lausd.net

 

 


About School-based Medi-Cal

 

In 1989, Congress enabled school districts to claim federal funds for health related services they provide to students enrolled in Medicaid. Districts can seek reimbursement from Medicaid for these services as long as the district is a Medicaid provider and meets requirements regarding licensure, certification, and other federal mandates for the Medicaid program.

 

Another federal law, the Individuals with Disabilities Education Improvement Act commonly known as IDEA, authorizes federal reimbursement for health related services specified in a Medicaid-eligible child’s IEP.

 

Medicaid is called Medi-Cal in California. California established its Local Education Agency (LEA) Billing Option Program in 1993 and it’s Medical Administrative Activities Program (MAA) in 1994.

 

In LAUSD, these two distinct Medi-Cal programs have the responsibility to recover costs from the federal government to offset the expenses of existing programs and to fund supplemental health and human services:

 

  • Local Education Agency Medi-Cal Billing Option Program

The Local Education Agency Medi-Cal Billing Option (LEA) is a fee-for-service program which includes direct assessment and services to Medi-Cal eligible children. Claims which capture this direct service are processed using the information entered by providers in the Welligent Service Tracking System (STS). For more information about the Medi-Cal Billing Option Program and the LEA Collaborative click here.


  • Medi-Cal Administrative Activities (MAA) Program

California established its Medi-Cal Administrative Activities Program (MAA) in 1994. MAA claims are reimbursement for indirect administrative activities. The District is required to conduct a quarterly Time Survey which is completed by District MAA participants in Welligent. For more information about MAA, including training and support documentation click here.