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Fact Sheets, Frequently Asked Questions, & Information Notices

The following are resources for the Drug Medi-Cal Organized Delivery System (DMC-ODS): 

Fact Sheets

Subject
Last Updated​
​October 2015
​Drug Medi-Cal Organized Delivery System Pilot Program ​December 2016
  

DMC-ODS Frequently Asked Questions

Subject​ ​Last Updated
Beneficiary Protections ​April 2016
Billing Frequently Asked Questions ​July 2017
Case Management ​February 2016
​Fiscal Considerations ​December 2016
Intensive Outpatient Treatment ​September 2016
Medication-Assisted Treatment ​October 2017
Partial Hospitalization ​April 2016
​Perinatal Beneficiaries ​June 2016
Program Eligiblity April 2018​
Quality Management ​June 2017
Readiness Review ​January 2018
Recovery Services ​August 2017
Residential Treatment Services ​October 2017
Staffing April 2018​
Withdrawal Management (Detoxification) ​February 2016
 

Waiver Information Notices 

The following information notices are related to the DMC-ODS waiver. For a complete list of Mental Health and Substance Use Disorder Services (MHSUDS) Information Notices, please visit the MHSUDS Information Notices webpage

​No Issued ​Subject ​Date
​18-020 ​Federal Provdier Directory Requirements for Mental Health Plans (MHPs) and Drug Medi-Cal Organized Delivery System (DMC-ODS) Pilot Counties ​4/24/2018
​18-019 ​Provider Credentialing and Re-Credentialing for Mental Health Plans (MHPs) and Drug Medi-Cal Organizd Delivery System (DMC-ODS) Pilot Counties ​4/24/2018
18-011

Federal Network Adequacy Standards for Mental Health Plans (MHPs) and Drug Medi-Cal Organized Delivery System (DMC-ODS) Pilot Counties

Enclosure 1 - contact DHCS MHSD Final Rule for a copy
Enclosure 2
Enclosure 3

2/13/2018​​
​18-010E

​Federal Grievance and Appeal System Requirements with Revised Beneficiary Notice Templates

Enclosure 1 Notice of Grievance Resolution (NGR)

Enclosure 2 Denial Notice (NOABD)

Enclosure 3 Payment Denial Notice (NOABD)

Enclosure 4 Delivery System Notice (NOABD)

Enclosure 5 Modification Notice (NOABD)

Enclosure 6 Termination Notice (NOABD)

Enclosure 7 Timely Access Notice (NOABD)

Enclosure 8 FInancial Liability Notice (NOABD)

Enclosure 9 NOABD Your Rights Attachment

Enclosure 10 Adverse Benefit Determination Upheld (NAR)

Enclosure 11 NAR Your Rights Attachment

Enclosure 12 Adverse Benefit Determination Overturned (NAR)

Enclosure 13 Beneficiary Non-Discrimination Notice

Enclosure 14 Language Assistance Taglines

Enclosure 15 Authorization Delay Notice

Enclosure 16 NOABD Grievance and Appeal Timely Resolution Notice

3/27/2018
​18-005 ​Drug Medi-Cal Organized Deliver System Case Management for Care Coordination Claiming 3/27/2018​
18-001 ​Drug Medi-Cal Organized Delivery System Residential Reimbursement 1/4/2018​
17-060 ​Drug Medi-Cal Organized Delivery System (DMC-ODS) Provider Selection Appeals Process 11/28/2017​
​17-047 ​Substance Abuse Prevention and Treatment Block Grant Coverage Gaps in Drug Medi-Cal and Drug Medi-Cal Organized Delivery System Waiver Substance Use Disorder Services 9/20/2017​
​17-046

​​Reporting Requirements Related to Provider Preventable Conditions in DMC-ODS Pilot Counties

9/20/2017​
17-045 Supercedes IN 17-002. Drug Medi-Cal Organized Delivery System Healthcare Common Procedure Coding System Waiver Substance Use Disorder Services ​9/14/2017
17-039​ Supercedes 17-023: Changing Same Day Billing Requirements for Counties that Opt-In to the Drug Medi-Cal (DMC) Organized Delivery System (ODS) 1115 Demonstration Waiver 8/18/2017​
17-038

​Updated Drug Medi-Cal (DMC) Billing Manual

7/31/2017​
17-036 ​Drug Medi-Cal County of Responsibility Transition 7/28/2017​
17-035​ ​American Society of Addiction Medicine (ASAM) Level Of Care (LOC) Data Collection for Drug Medi-Cal Delivery System (DMC-ODS) Waiver 9/5/2017​
17-034 International Classification of Diseases, Tenth Revision (ICD-10) Substance Use Disorder (SUD) Remission Codes for the Drug Medi-Cal Organized Delivery System (DMC-ODS) 7/27/2017​
17​-033 ​Deadline to Submit Drug Medi-Cal Organized Delivery System Fiscal Plan - November 1, 2017 ​7/31/2017
​17-030 ​State Health Information Guidance (SHIG) for Sharing Behavioral Health Information in California 6/26/2017​
17-029

​Medical Assisted Treatment Reimbursement Rates for Fiscal Year 2017-18 Under the Drug Medi-Cal Organized Delivery System

​6/26/2017
17-026​

​Drug Medi-Cal Organized Delivery System (DMC-ODS) Treatment Perceptions Survey

6/9/2017​
17-023

​Changing Same Day Billing Requirements for Counties That Opt-In To The Drug Medi-Cal Organized Delivery System (DMC-ODS) 115 Demonstration Waiver

​5/25/2017
17-022​ ​Deadline to submit a Drug Medi-Cal Organized Delivery System Implementation Plan 5/24/2017​
17-020

​Short-Doyle Medi-Cal (SD/MC) Claim Adjustment Reason Code and Remittance Advice Remark Code for the Drug Medi-Cal Organized Delivery System

5/26/2017​
17-017

​Alcohol and/or Other Drug Program Certification Standards

​5/​24/2017
​17-011 Reimbursement for Drug Medi-Cal Organized Delivery System Quality Assurance and Utilization Review Expenses 4/14/17​
17-008​

​Peer Support Services in the Drug Medi-Cal Organized Delivery System (DMC-ODS) Waiver

​2/14/2017
17-002 ​Drug Medi-Cal Organized Delivery System Healthcare Common Procedure Coding System and Modifiers ​1/24/2017
​16-063 ​​Substance Use Disorder (SUD) Treatment Services for Youth in California 12/21/2016​
16-059 ​Substance Abuse Prevention and Treatment Block Grant Funded Room and Board For Transitional Housing, Recovery Residences and Residential Treatment Services ​11/15/2016​
​16-057 ​Drug Medi-Cal Organized Delivery Systems Healthcare Common Procedure Coding System (HCPCS) and Modifiers ​11/9/2016
​16-050

​Drug Medi-Cal Organized Delivery System Waiver County Implementation Fiscal Plan Guide

​10/4/2016
​16-048

​Medication Assisted Treatment in Narcotic Treatment Programs Under the Drug Medi-Cal Organized Delivery System Pilot Program

​9/27/2016
​16-044 ​Clarifying the Meaning of "Face-to-Face Review" from Standard Terms of Conditions for the Drug Medi-Cal Organized Delivery Systems (DMC-ODS) ​9/14/2016
16-042 ​Residential Treatment Services and Residential Authorizations in the Drug Medi-Cal Organized Delivery System (DMC-ODS) Pilot Program ​8/11/2016
​16-037 ​Medically Monitored and Medically Managed Detoxification/Withdrawal Management and Residential Treatment Services in the DMC-ODS Pilot Program ​7/20/2016
​16-035 ​Drug Medi-Cal Organized Delivery System Healthcare Common Procedure Coding System (HCPCS) and Modifiers ​7/20/2016
16-009 ​State General Fund Quarterly Claiming Process for Drug Medi-Cal Organized Delivery System Participating Counties ​3/17/2016
16-007 ​Changing Same Day Billing Requirements for Counties that Opt-In to the Drug Medi-Cal Organized Delivery System (DMC-ODS) 1115 Waiver ​2/8/2016
​16-006 ​Drug Medi-Cal Organized Delivery System Waiver County Implementation Fiscal Plan Guide ​2/5/2016
​16-005 ​Drug Medi-Cal Organized Delivery System Waiver Implementation Plan Guide ​2/18/2016
​15-048 ​Addition of Withdrawal Management (Detox) Services ​10/12/2015
​15-035 ​American Society of Addiction Medicine (ASAM) Designation for Residential Facilities ​8/26/2015
​15-034 ​Drug Medi-Cal Organized Delivery System Pilot Fiscal Provisions ​8/20/2015
15-033 ​Medications Used in Treatment of Substance Use Disorders in an Outpatient Setting ​8/14/2015
​15-032 ​Drug Medi-Cal Organized Delivery System Waiver Approval ​8/13/2015
 

 

Last modified on: 5/4/2018 2:15 PM