California Healthline: Payments Delayed to CBAS Centers

by David Gorn

California centers that offer adult day services are having trouble getting reimbursed for services provided to Medi-Cal beneficiaries under the state’s new Community Based Adult Day Services program launched on Oct. 1.

“We are not getting paid. And I don’t know when we will get paid. I’m not expecting anything at this point,” said Manooch Pouransari, who runs the Grace Adult Day Health Care center in Santa Clara.

“My experience is similar to many other centers,” he said. “We haven’t been told who to bill, where to bill, how to bill. And we found the same thing on their side, the MCOs (managed care organizations), they don’t know any of that, either.”

It may be a little early to pass judgment, since the CBAS program really just started, said Norman Williams, director of public affairs for the Department of Health Care Services.

“Because this system has been in effect only since Oct. 1, DHCS does not have sufficient claims data to assess the scope of the problem,” Williams said. “DHCS is committed to ensure access to services that help these vulnerable individuals remain independent and in their communities.”

He said part of the CBAS effort is to monitor just this kind of thing, and the department has already checked in with the health plans setting up the billing systems.

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  • LAAAC is managed by St. Barnabas Senior Services; Funded, in part, by Archstone Foundation.
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