In a recent incident DHCS learned that incentive payments for providers in a group/clinic had been mistakenly designated for receipt by providers when in fact the providers and the group/clinic had intended for the payments to be made to the group/clinic.  This occurred because a group/clinic representative, acting as a proxy for providers in the National Level Registry (NLR), had mistakenly designated the providers as payees for the payments.  The providers, group/clinic, and DHCS did not realize this until after the applications had been approved by both DHCS and CMS.  Unfortunately, CMS does not currently have the capacity to change the designated payee after approvals have been granted. DHCS does not collect payee information in the State Level Registry (SLR), and only receives this information from CMS through the NLR.

To help prevent similar episodes in the future, providers and group/clinic representatives are urged to check the information that has been entered into the NLR before entering information into the SLR.  This can be done by clicking on the “View CMS Data” link on the homepage or Step 1 (About You) of the SLR. In the future DHCS intends to redesign the SLR to require active affirmation by the applicant that the information the SLR has received from the NLR is current and accurate before the applicant will be allowed to continue with the application.  Providers who have already applied for 2011 or 2012 payments in the SLR (but may not have yet been approved for payment by DHCS and CMS) are able to check their NLR information by clicking on the “View CMS Data” link on the SLR homepage or Step 1 (About You) and can go to the NLR to make any necessary changes since their accounts will not yet have been locked.

California Department of Health Care Services
Office of Health Information Technology
1501 Capitol Avenue, MS0004
Sacramento, CA 95814
(916) 552-9181

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