Section 1202 of the Affordable Care Act (ACA) increases payments to the Medicare equivalent for specified services for qualified Medi-Cal providers effective January 1, 2013 through December 31, 2014. In order to be eligible for enhanced payment, the physician rendering or supervising the service or, the rendering nurse practitioner must personally attest to the following:
- Currently practicing in the area of General Internal Medicine, Family Medicine, or Pediatric Medicine, or a subspecialty under one of those specialty designations (FQHCs and RHCs are excluded).
- Meet at least one of the following qualifications:
- Board Certified in a specialty or sub-specialty listed above.
- At least 60% of total codes billed or paid were for E&M (99201 - 99499) and Vaccine Administration (90460, 90461, 90471 - 90474, or their successors) services.
Santa Clara Family Health Plan (SCFHP) will not be providing or collecting the self-attestation forms. SCFHP will obtain provider self-attestation information directly from the Department of Health Care Services (DHCS). Visit the DHCS web site to see if you qualify for the enhanced payment and to complete the self-attestation form:
Please note: Providers only need to complete the form once, and can make updates as needed. You do not need a separate attestation for each plan you contract with.
Please contact our Provider Relations Department at 1-408-874-1788 if you have questions.