Medicaid billing records (ISSTD attendees in CA)

Evan Anderson filed this request with the Department of Health Care Services of California.

It is a clone of this request.

Est. Completion Feb. 26, 2018
Status
No Responsive Documents

Communications

From: Evan Anderson

To Whom It May Concern:

Pursuant to the California Public Records Act (California Government Code §§ 6250), I hereby request the following records:

A spreadsheet of Medicaid billing records from 1/1/2000 through 2017. Specifically, I am interested in information related to the service provided (for example, psychotherapy), the primary diagnosis related to the service provided, and the amount reimbursed, for the following NPIs:
1336353689
1912079518
1093259632
1467731075
1891963906
1861647034
1407886989
1780718403
1508173717
1891872164
1982946117
1053512525
1043634710

The requested documents will be made available to the general public, and this request is not being made for commercial purposes.

In the event that there are fees, I would be grateful if you would inform me of the total charges in advance of fulfilling my request. I would prefer the request filled electronically, by e-mail attachment if available or CD-ROM if not.

Thank you in advance for your anticipated cooperation in this matter. I look forward to receiving your response to this request within 10 calendar days, as the statute requires.

Sincerely,

Evan Anderson

From: Department of Health Care Services

Hi Evan, good afternoon.

The California Department of Health Care Services (DHCS) received your email dated January 20, 2018, requesting records under the Public Records Act (PRA).

DHCS is in the process of determining if it possesses responsive information. Your request will take extra time to fulfill because we must consult with multiple components of the Department. Consequently, DHCS is exercising its authority under Government Code, Section 6253, subdivision (c), to extend the time to reply to a PRA request. By February 14, 2018, we will update you on the status of our response.
Thanks,
Tony

Anthony Cava
Spokesman, Office of Communications
Department of Health Care Services
(916) 440-7660

From: Department of Health Care Services

Hi Evan, good afternoon.

Per my January 31, 2018, email to you in response to your PRA request, I advised you that I would update you on the status of our response by February 14, 2018.

Please know that staff continue to gather responsive data. We are planning to provide a summary of approved claims for the NPIs listed in your request. However, we will be withholding the requested records related to the service provided, as well as the primary diagnosis related to the service provided, due to privacy laws. Specifically, we would be withholding this information on the following legal bases:

· Title 42 United States Code, Section 1320d-2

· 45 Code of Federal Regulations, Sections 164.500-164.534

· California Civil Code, Section 1798

· California Government Code, Section 6254, subdivision(c)

· California Government Code, Section 6254, subdivision(k)

We hope to share with you responsive information during the week of February 26. Please let me know if you have any questions.
Thanks,
Tony

From: Department of Health Care Services

Hi Evan, I wanted to let you know that staff continue to work on your request.
Thanks,
Tony

From: Department of Health Care Services

Hi Evan, good morning.

I emailed you on 2/28 to let you know that we are still working on your request. Staff continue to work on your request. I’ll check with staff on an estimated completion date and get back to you. Thanks.

Tony

From: Department of Health Care Services

Hi Evan, good afternoon.

Per my March 15, 2018, email to you replying to your email seeking the status of our response to your PRA request, please be advised that staff continue to gather responsive data. However, staff have determined that the data you requested are only available from 2010 to 2017, and expert review and determination of the data is needed before it can be released. The estimated completion date is mid to late April. I will contact you when the data are ready. Thanks.

Tony

From: Department of Health Care Services

Hi Evan, good afternoon.

On January 20, 2018, the California Department of Health Care Services (DHCS) received your email requesting records under the Public Records Act. Specifically, you requested Medi-Cal billing records of 13 providers you identified by NPI from January 1, 2000, through 2017, including service provided, the primary diagnosis related to the service provided, and the amount reimbursed.

We have conducted an extensive search of our records, and we do not possess the information you requested.

If you have questions regarding this matter, please do not hesitate to contact me. Thanks.

Tony

Anthony Cava
Spokesman, Office of Communications
Department of Health Care Services
(916) 440-7660

---

On Jan. 20, 2018:
To Whom It May Concern:

Pursuant to the California Public Records Act (California Government Code §§ 6250), I hereby request the following records:

A spreadsheet of Medicaid billing records from 1/1/2000 through 2017. Specifically, I am interested in information related to the service provided (for example, psychotherapy), the primary diagnosis related to the service provided, and the amount reimbursed, for the following NPIs:
1336353689
1912079518
1093259632
1467731075
1891963906
1861647034
1407886989
1780718403
1508173717
1891872164
1982946117
1053512525
1043634710

The requested documents will be made available to the general public, and this request is not being made for commercial purposes.

In the event that there are fees, I would be grateful if you would inform me of the total charges in advance of fulfilling my request. I would prefer the request filled electronically, by e-mail attachment if available or CD-ROM if not.

Thank you in advance for your anticipated cooperation in this matter. I look forward to receiving your response to this request within 10 calendar days, as the statute requires.

Sincerely,

Evan Anderson

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From: Evan Anderson

Hi there,

Thank you for the response. I am a little confused, however. Should I interpret this to mean that your agency is not in possession of Medicaid claims data? If that is the case, can you direct me to the agency which would have these data? If that is not the case, can you be more specific about the mismatch between what you are in possession of and what I am seeking?

Best,
Evan

From: Department of Health Care Services

Hi Evan,

To clarify, DHCS does have claims data for Medi-Cal providers. However, we do not have claims data for the 13 providers listed in your request.
Thanks,
Tony

From: Evan Anderson

Thank you!

Evan

From: Evan Anderson

Would you be able to check one more for me? It's NPI number 1639585623. Thank you.

Sincerely,
Evan

From: Department of Health Care Services

Hi Evan, good morning.

We conducted a search of our records, and we do not possess any responsive information for the additional NPI number you provided.
Thanks,
Tony

From: Evan Anderson

Hi,

Thanks so much for your help with this request! I really appreciate it.

Sincerely,
Evan Anderson

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