Family PACT


Provider Updates 

 Family PACT Client Eligibility Verification Issue

The Department of Health Care Services (DHCS) has resolved the issue of using the Family Planning, Access, Care and Treatment (Family PACT) Internet Transaction application to inquire about Family PACT eligibility status.  Providers can now use the Internet Transaction application or Automated Eligibility Verification System (AEVS) to verify Family PACT client's eligibility.

Availability of long-acting reversible contraceptives in Los Angeles County clinics through a Medicaid state plan amendment program  Full Article

Objective

To assess the availability of long acting reversible contraceptive (LARC) methods in Los Angeles County through providers participating in a California State Medicaid State Plan Amendment Program called Family Planning, Access, Care and Treatment (Family PACT).

Study design

This was a cross-sectional telephone survey utilizing “secret shopper” methodology. From 855 Family PACT providers in Los Angeles County in 2015, a representative sample of 400 providers was selected for study. Young female researchers posing as potential patients called each sampled clinic to ask a scripted series of questions about LARC availability for Family PACT patients in that practice.

Results

All but one eligible practice (99.7%) responded to our questions. Among the 336 responding practices, 284 said they accepted Family PACT. Of those accepting Family PACT, staff answering the telephone call at 61% said they did not provide any LARC method onsite, 2% provided all currently available LARC methods, and 6% provided same-day placement of any LARC.

Conclusion

The majority of Family PACT practices surveyed said that they did not provide any LARC onsite, and very few provided same-day LARC placement despite easy patient enrollment procedures, relatively reasonable reimbursement and concerted efforts to increase LARC use. Substantial barriers to greater uptake may rest at the provider level with either actual unavailability of LARC or staff perception of unavailability.

Implications

Only a minority of Family PACT practices said that LARC methods were available onsite, which imposes substantial restriction to access for women who are entitled to have access without cost. Other states developing programs should be aware of this challenge.

Select Comprehensive Family Planning Services Policy Update

The Family Planning, Access, Care and Treatment (Family PACT) program will provide time-limited supplemental payments, to Family PACT providers for Evaluation and Management (E&M) office visits rendered for comprehensive family planning services for the period of July 1, 2018 through June 30, 2019. These supplemental payments are equal to 150 percent of the reimbursement amount for procedure codes 99201, 99202, 99203, 99204, 99211, 99212, 99213, and 99214.

Accuracy and Correction of Claims or Payments

Family PACT providers are responsible for all claims submitted regardless of who completes the claim on behalf of the provider. Family PACT providers are responsible for the review and verification of the accuracy of claims payment information promptly upon the receipt of any payment. The Family PACT provider agrees to seek correction of any claim errors through the appropriate processes as designated by the Department of Health Care Services or its fiscal intermediary (Source: Medi-Cal Provider Manual, Part I and your signed Form DHCS 6153, Medi-Cal Telecommunications Provider and Biller Application/Agreement).

ACA's Nondiscrimination Policy Applies to Family PACT

Section 1557 of Patient Protection and Affordable Care Act (ACA) prohibits discrimination on the basis of race, color, national origin, sex, age or disability in certain health programs or activities. In effect since 2010, Section 1557 builds on long-standing federal civil rights laws: Title VI of the Civil Rights Act of 1964; Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of 1973 and the Age Discrimination Act of 1975.

Effective July 18, 2016, the Health and Human Services (HHS) Office for Civil Rights issued its final rule implementing Section 1557 at Title 45 Code of Federal Regulations (CFR) Part 92. 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. In addition to other requirements, Title 45 CFR Part 92.201, requires:

  • Language assistance services requirements
    Language assistance services required under paragraph (a) of Part 92.201 must be accurate, timely and provided free of charge, and protect the privacy and independence of the individual with limited English proficiency
  • Specific requirements for interpreter and translation services
    Subject to paragraph (a) of Part 92.201:
  • A covered entity shall offer a qualified interpreter to an individual with limited English proficiency when oral interpretation is a reasonable step to provide meaningful access for that individual with limited English proficiency
  • A covered entity shall use a qualified translator when translating written content in paper or electronic form.

For more information about the application and requirements of the final rule implementing Section 1557, providers should contact their representative professional organizations. They may also visit the Section 1557 of the Patient Protection and Affordable Care Act page of the HHS website to find sample materials and other resources.

Information Related to Insurance Affordability Programs

An informational video for providers ACA Requirements for ORP Providers Available on ORP Web Page.   Read more...

NEW

November 2018 Family PACT Update                          

  •     Family PACT Update: Cervical Cancer Screening and HPV Testing
  •     Corrected Reimbursement Rates for Select HCPCS Codes
  •     Family PACT Update: Copper IUC Reimbursable as a Pharmacy Benefit
  •     Provider Orientation
  •     Get the Latest Medi-Cal News: Subscribe to MCSS Today
  •     Provider Manual Revisions                   
     

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