Medi-Cal UBL

Medi-Cal Upper Billing Limit - UPDATE

You may be at risk for billing Medi-Cal their fee schedule allowable!

The California Association of Medical Products Suppliers (CAMPS) determined that it was necessary to file a legal challenge to the Upper Billing Limit (UBL) regulation implemented by Medi-Cal in 2004. This regulation poses a severe threat to the DME provider community. Since adoption, the UBL has had little or no enforcement or recognition by providers. The UBL is foreign to the Medi-Cal coding and reimbursement of DME/medical supply items and is incomprehensible to most providers. In addition, CAMPS has received notice from providers who have been assessed penalties and suffered recoupment of previous Medi-Cal payments.

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CAMPS has been waiting for some time for oral arguments to be scheduled on this matter, and received notice this week that the UBL appeal will be heard in the Court of Appeals in San Francisco, August 18, 2011. A decision should come down within 90-days of the hearing.

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CAMPS continues to accrue legal fees related to defeating the UBL regulation that is so detrimental to the DME provider community. There remains a need to raise funds in order to continue the legal battle on behalf of our membership. Please consider donating to the Fight the Medi-Cal Upper Billing Limit Legal Fund. We need your help to win this fight!

Please send your contribution today. If you have questions, please contact me at the CAMPS office or by e-mail at bachermann@amgroup.us.