What is the Medi-Cal LEA Billing Option Program?
The Local Educational Agency (LEA) Medi-Cal Billing Option Program provides federal financial participation (FFP) reimbursement to LEAs (school districts, county offices of education, community colleges, and university campuses) for health-related services provided by qualified medical practitioners to students receiving special education services and who are on Medi-Cal.
The LEA Medi-Cal Billing Option Program was established in 1993 in conjunction with the California Department of Education (CDE). It is authorized under California’s Welfare and Institutions Code 14132.06. Reimbursement is based upon a “fee-for-service” model. School expenditures for services rendered are reimbursed at 50% of cost.
https://www.dhcs.ca.gov/provgovpart/Pages/LEA.aspx
The purpose of the LEA Billing Option is to:
- Allow LEAs to become Medi-Cal providers and bill the Medi-Cal program for the health services provided by employed or contracted medical professionals.
- Facilitate reinvestment in health and social services for students and their families so that schools can provide comprehensive health services to eligible Medi-Cal students.
- The funds are reimbursement for services rendered and are not considered federal dollars upon receipt by the school and therefore can be used as match to draw down additional federal dollars.
- The funds are restricted in their use, they must supplement existing services, not supplant.
- The fund expenditures are overseen by an interagency collaborative led by the school and must meet the regulations as listed in the California Education Code 8804(g) that are focused on improving student’s health and a variety of other services delineated in the Education Code.
ELIGIBLE SERVICES
- Health and Mental Health Evaluation/Assessments
- Physical Therapy
- Occupational Therapy
- Speech Therapy
- Orientation and Mobility Therapy
- Audiology Services
- Psychology and Counseling
- Nursing Services
- School Health Aid Services
- Medical Transportation and Mileage
- Targeted Case Management Services *
All revenue received for services claimed is restricted and can only be utilized to supplement programs and services to the students and families of our district. A collaborative committee has been formed for this purpose.
About Our Billing Vendor
In January of 2010 School Based Reimbursement Partners LLC (SBR) was created to provide LEAs with a cutting edge WEB application for Medi-Cal billing and customer support services.
SBR is a family-owned and operated business. They take pride in the work they do to ensure that our district has a positive experience with the LEA Billing program.
SBR is a company based in Southern California with the resources, experience, and education needed to follow through with their promise to make Medi-Cal billing easier.
SBRpartners Training Guides
For program-specific questions, please contact Sheila de Anda.
For students missing in the SBR system, and individual training, please contact Elise de Anda.
