Frequently Asked Questions​

The Department of Managed Health Care (DMHC) released All Plan Letter APL 23-016 – Implementation of SB 1338 (2022) – Community Assistance, Recovery, and Empowerment (CARE) to provide guidance about how health plans shall ensure they identify enrollees who are involved in CARE proceedings and process and pay claims arising from their enrollees’ CARE agreements or CARE plans. The Billing Health Plans for CARE Act Activities brief is designed to help providers understand and implement effective strategies and processes for health plan/managed care plan (MCP) billing activities related to services and supports provided when a beneficiary is participating in the CARE process. If a claim for services provided under CARE is denied, you have the right to dispute the denial through the Department of Managed Healthcare’s Independent Medical Review & Complaint Process.

As outlined in the Behavioral Health Information Notice (BHIN) 24-015: CARE Act Reimbursement Rates and Billing Guidance, the Department of Health Care Services (DHCS) will reimburse counties an hourly rate for time spent performing the following administrative activities: Court Hearing Time, Court Report, Outreach and Engagement, Notice, and Data Reporting. The BHIN provides details and examples of these activities and outlines the rate for each CARE activity. Hours spent performing each CARE Act activity include time ancillary to the performance of the activity, which is limited to preparation time, internal meeting time, and oversight by supervisors and managers related to the activities. For more information, review the Claiming for Administrative Activities Related to CARE brief, the Administrative Claiming for the CARE Act training, and FAQs related to Claims / Billing & Sanctions. For additional questions, contact [email protected].

Yes, counties are able to claim for administrative functions outlined in Behavioral Health Information Notice (BHIN) 24-015: CARE Act Reimbursement Rates and Billing Guidance that are completed by a subcontractor. The county would need to include the subcontractor’s name and role in the claim form. For more information, review the Claiming for Administrative Activities Related to CARE brief, the Administrative Claiming for the CARE Act training, and FAQs related to Claims / Billing & Sanctions. For additional questions, contact [email protected].

County behavioral health agencies should not bill for public defender services to the Department of Health Care Services (DHCS). Public defenders should bill 100% of their CARE contracts with the Legal Services Trust Fund Commission (LSTFC). For additional questions, contact [email protected].

Ancillary activities include time spent preparing for a primary activity outlined in the Behavioral Health Information Notice (BHIN) 24-015: CARE Act Reimbursement Rates and Billing Guidance. These ancillary activities account for extra or supporting time included in the hours spent performing each primary CARE Act activity—namely preparation, internal meetings, and oversight by supervisors and managers.

• Preparation: Time spent getting ready for a task. For example, preparing for a hearing can be reported under Court Hearing Time.
• Internal Meetings: Discussions and planning related to specific activities. For instance, meetings to develop outreach strategies for a CARE respondent may be reported under Outreach and Engagement.
• Supervisory Oversight: Time spent by supervisors and managers overseeing the work done in each category. For example, time spent reviewing and approving a court report may be claimed under Court Reporting.

For additional information, please review the Claiming for Administrative Activities Related to CARE brief, the Administrative Claiming for the CARE Act training, and FAQs related to Claims / Billing & Sanctions. For additional questions, contact [email protected].

The Employee Type by Category/Activity dropdown in the CARE Act Claiming Workbook are examples, not a complete list of all possible staff types. Select the employee type that best matches the staff performing the activity. CARE Act activity rates are based on the Category/Activity (e.g., Court Hearing, Court Report, Notice), not the employee type.

Claims may be submitted for CARE Act administrative activities performed by multiple employees for the same task by adding each additional employee on a separate line in the Claiming Workbook. For example, if two employees serve a notice or participate in an outreach and engagement activity, both employees can be included in the claim.

For additional information, please review the Claiming for Administrative Activities Related to CARE brief, the Administrative Claiming for the CARE Act training, and FAQs related to Claims / Billing & Sanctions. For additional questions, contact [email protected].