The City will reimburse only for eyeglasses provided to uninsured students. Respondents must purchase frames and prescription lenses using materials equivalent to those used by Medicaid and MCOs for non-Medicaid students. The selected optical lab must meet the following requirements: a) The cost of eyeglasses must not exceed $5 per pair; any additional costs will be the responsibility of the Respondent. b) Eyeglasses must be produced and delivered within ten business days of the examination. c) The lab must provide a warranty covering the replacement of damaged or lost glasses, as well as refitting for all students. d) The lab must be an approved Medicaid and MCO vendor. Alternatively, Respondents may choose to purchase frames and lenses from the CPS-selected optical lab, which meets all of the above criteria. In this case, Respondents are required to initially reimburse the CPS-selected lab for the cost of eyeglasses and will subsequently be reimbursed by the City for eyeglasses provided to uninsured students. The reimbursement model is based on a payer schedule assuming that at least 60% of students served are Medicaid and/or MCO eligible. If a respondent’s payer mix falls below this threshold during the contract period, the respondent must notify CDPH and CPS. The program will collaborate with the respondent to implement strategies aimed at increasing participation among Medicaid-eligible students.
