Annual Cost Report Instructions

Pursuant to your Agency contracts with the Department of Public Health Substance Abuse Prevention and Control (SAPC), each Provider must submit accurate and complete cost reports for the previous fiscal year by August 30 following the end of the fiscal year except Drug Medi-Cal (DMC).

New:

• FY 2018-19 annual DMC cost report submission due date is undetermined at this point due to the processing of the denied units. Once SAPC distribute the State Reconciliation Report in August 2021, the cost report submission due date will be informed.
• Contract Performance reports from sage are available upon request.

The following documents/files must be submitted by your Agency for the cost report to be considered complete:

Non-Drug Medi-Cal (NON-DMC)

1. Original Cost Report - E-mail completed cost report(s) in Excel format to your assigned analyst.
2. Mail "Provider Information and Certification" with original signature.

Drug Medi-Cal (DMC)

1. Original Cost Report (by Site) - E-mail completed cost report(s) in Excel format to your assigned analyst.
2. Mail "Provider Information and Certification" with original signature.

Driving Under the Influence (DUI) Program

1. Original Cost Report (by Program) - E-mail completed cost report(s) in Excel format to your assigned analyst.
2. Mail the original cost report with original signature.

IMPORTANT:

• If the cost reports are not received by the due date, your agency will be listed as delinquent.
• After the due date, a stop payment will be placed on current billings for delinquent providers.
• The Stop payment order will remain until such time cost reports are received.
• Do not staple or bind cost reports.

SETTLEMENT:

• Participant/client fees and third-party revenue (insurance paid) collected will be offset from allowable cost.

COST REPORT SUBMISSION:
Please send original cost reports with all working papers as applicable to:

County of Los Angeles Department of Public Health
Substance Abuse Prevention and Control
Cost Reporting Unit
1000 S. Fremont Ave., Bldg A-9 East
3rd Floor, North Wing, Unit 34
Alhambra, California 91803

COST REPORT FORMS/INSTRUCTION AND POWERPOINT

Drug Medi-Cal Funded Contracts (DMC) FY 2018-19 Drug Medi-Cal Cost Report Forms and Instructions Drug Medi-Cal Cost Report Reference Non-Drug Medi-Cal funded Contracts Cost Report Forms and Instructions Non-Drug Medi-Cal Cost Report Reference Driving Under The Influence (DUI) Program Cost Report Forms and Instructions