Telehealth Amendment (Effective November 12, 2023, this amendment adds telehealth as a permanent service delivery option for the following: Care Coordination, Augmented Plan of Care Development and Follow-Up, NF Transition Care Coordination.)
Approved Appendix K Southern California Wildfires (Effective January 7, 2025), in response to the Los Angeles and Ventura Counties Fire, which has burned over 70,000 acres, prompted evaluation orders and road closures, and continues to threaten structures, homes, and critical infrastructure. This amendment, temporarily expands the settings in which services can be provided and permits retainer payments for certain services. Additionally, the amendment authorizes a temporary suspension of the enrollment period and extension of the reenrollment period.. The listed flexibilities are authorized under this amendment apply to waiver participants impacted by the State of Emergency in Los Angeles and Ventura Counties.
DHCS obtained approval for flexibilities accepted under the federal 1135 waiver authority which will expire January 7, 2026, for Los Angeles and Ventura Counties. The following flexibilities are available immediately.
Permit evacuating facilities (such as ICF-DDs, SNFs) to be fully reimbursed for services rendered to affected beneficiaries in alternative physical settings, such as temporary shelters or other care facilities.
Permit some services to continue to be provided without a requirement for a new or renewed prior authorization.
Temporarily allow services to be provided in settings that have not been determined to meet the HCBS Settings Rule criteria.
Temporarily extend the timeframe to reinstate services and benefits to an individual who files a fair hearing request.
