Principales noticias​​ 

Nueva Solicitud Federal del DHCS sobre Flexibilidad de Activos Durante la Reversión Continua de la Cobertura​​ 

On March 10, DHCS submitted a waiver flexibility request to the Centers for Medicare & Medicaid Services (CMS) to support the unwinding of the continuous coverage requirement. The Section 1902(e)(14)(A) waiver flexibility seeks to make it easier for Non-Modified Adjusted Gross Income (MAGI), for example seniors and persons with disabilities, to renew their Medi-Cal coverage—and remain covered until California eliminates the asset limit on January 1, 2024. It will allow counties to use existing case file information to grant eligibility during renewals, and disregard any increases in assets since the last Medi-Cal determination. Also, for individuals who were not initially subject to an asset test at the time of their Medi-Cal application, but have now transitioned into a program requiring one, the waiver flexibility would allow California to renew based on their last known eligibility determination on file. DHCS is requesting this authority to be effective retroactive to March 1, 2023, and remain in effect through December 31, 2023.​​ 

The requested waiver flexibility only applies to Medi-Cal renewals and not to new applications. New Medi-Cal applications, specifically for Non-MAGI programs, are still subject to the asset test until it is eliminated. The asset test for new Medi-Cal non-MAGI applications was raised to $130,000 per individual and $65,000 per additional person on July 1, 2022. It is important to note that non-MAGI Medi-Cal members will still need to meet all other Medi-Cal eligibility criteria, including income, to remain Medi-Cal eligible at redetermination.​​ 

Una vez que los CMS lo aprueben, el DHCS emitirá una guía inmediata a los condados a través de una carta informativa de la División de Elegibilidad de Medi-Cal.​​  

Program Actualizaciones​​ 

Expansión de los planes Medi-Medi en 2024 a otros condados​​ 

Starting January 1, 2024, DHCS will expand the availability of Medi-Medi Plans for dual eligible Medicare and Medi-Cal members to five additional central valley counties: Fresno, Kings, Madera, Sacramento, and Tulare. Medi-Medi Plans for dual eligible Medicare and Medi-Cal members are currently available in the seven former Coordinated Care Initiative (CCI) counties: Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Mateo, and Santa Clara.​​ 

Medi-Medi Plans is the California-specific program name for Medicare Advantage Exclusively Aligned Enrollment Dual Eligible Special Needs Plans (D-SNPs). Under Medi-Medi Plans, dual eligible members can voluntarily enroll in a D-SNP for Medicare benefits and in a Medi-Cal managed care plan (MCP) for Medi-Cal benefits, which are both operated by the same parent organization for better care coordination and integration.​​ 

DHCS se está reuniendo con las partes interesadas locales en los cinco condados en expansión para proporcionar más información sobre los planes Medi-Medi, e incluirá este tema en futuras reuniones del Grupo de Trabajo de Servicios y Apoyos Administrados a Largo Plazo e Integración de Duales. Más información sobre los planes de Medi-Medi está disponible en la página web de los planes de Medicare Medi-Cal. Envíe un correo electrónico a OMII@dhcs.ca.gov si tiene alguna pregunta.​​ 

Proyecto de Navegadores de Inscripción en Salud​​ 

El Proyecto de Navegadores realizó recientemente actualizaciones del sitio web para proporcionar información más específica para las comunicaciones de defensores y partes interesadas, socios del proyecto y anuncios generales / otras comunicaciones. El sitio web de los socios del proyecto también incluye información específica relacionada con las adjudicaciones de fondos del Proyecto de Ley del Senado (SB) 154, una lista de organizaciones comunitarias locales y entidades subcontratadas por condado, y el Resumen de los socios del proyecto, que detalla los esfuerzos de trabajo de alto nivel, como las metas de inscripción y retención, los montos de financiamiento, los subcontratistas y las poblaciones objetivo a las que se atiende.​​ 

Aprobación federal de la administración de la vacuna contra la viruela símica para clínicas​​ 

CMS recently approved a State Plan Amendment (SPA) to reimburse vaccine-only encounters at the fee-for-service (FFS) rate at certain clinics, retroactive to August 17, 2022. SPA 22-0062 pertains to Federally Qualified Health Centers (FQHC), Rural Health Clinics (RHCs), Indian Health Services Memorandum of Agreement (IHS-MOA), and Tribal FQHC clinic providers.​​ 

Effective March 10, 2023, FQHC, RHC, IHS-MOA, and Tribal FQHCs may submit claims for members enrolled in Medi-Cal managed care for Mpox vaccine-only encounters. Likewise, claims for FFS members may be submitted by FQHC, RHC, IHS-MOA, and Tribal FQHC providers using the instructions published in the December 13, 2022, article “Mpox Vaccines Reimbursement at the Medicare Rate“.​​ 

This reimbursement policy is effective for dates of service on or after August 17, 2022, through January 31, 2023, the end of the Mpox state public health emergency (PHE). At the conclusion of the PHE, the reimbursement rates for Mpox vaccine administration returned to the Medi-Cal FFS rates in effect at that time. Providers are reminded that each administration of the Mpox vaccine falls under a qualifying office visit or vaccine-only encounter, not both.​​ 

FQHC, RHC, IHS-MOA, and Tribal FQHC providers will receive a 120-day timeliness override to submit the Mpox vaccine-only encounters.​​ 

Solicitud de Liberación de Solicitud (RFA) de Salud Indígena Tradicional (TIH)​​ 

During the week of March 20, DHCS anticipates the release of a RFA to fund three TIH education programs that will assist Indian clinics in providing services to American Indians in a culturally appropriate manner and to provide a forum for the Indian community to address TIH education. A total of $300,000 is available to fund regional TIH programs for two fiscal years. This funding opportunity supports the provision of traditional Indian health care. Funds for this project are part of the $11,576,000 allocated in the fiscal year 2022-23 budget for the restoration of Indian Health Program grant programs.​​ 

It is anticipated that $100,000 per region will be made available to support each regional program for two fiscal years. The maximum funding is $50,000 per region per fiscal year. The grant term is projected to start in May 2023 and continue through June 30, 2024.​​ 

For questions about the RFA, please email TribalAffairs@dhcs.ca.gov.​​ 

Únete a nuestro equipo​​  

DHCS está contratando para nuestros equipos fiscales, de recursos humanos, legales, de auditoría, de políticas de salud y de tecnología de la información. Para obtener más información, visite el sitio web de CalCareers.​​   

DHCS is dedicated to preserving and improving the overall health and well-being of all Californians. DHCS’ mission is to provide the most vulnerable residents with equitable access to affordable, integrated, and high-quality health care, and is currently transforming the Medi-Cal program to make sure it provides the care Californians need to live healthier, happier lives.​​  

Próximas reuniones de partes interesadas y seminarios web​​ 

California’s Reproductive Health Access Section 1115 Demonstration: Tribal and Designee of Indian Health Programs Webinar​​ 

On March 20, from 9 to 10 a.m., DHCS will host a Medi-Cal Tribal and Designee of Indian Health Programs webinar (advance registration required) to provide information and receive feedback on California’s Reproductive Health Access Demonstration (CalRHAD) 1115 request in advance of DHCS’ submission to CMS. Tribal partners have been invited to participate in the webinar via email.​​ 

California’s Reproductive Health Access Section 1115 Demonstration: First Public Hearing​​ 

On March 29, from 10 to 11 a.m., DHCS will host the first (advance registration required) of two public hearings to solicit stakeholder comments on a proposed CalRHAD Medicaid Section 1115 demonstration. DHCS is seeking approval from CMS to provide competitive grants to reproductive health providers to enhance capacity and access to sexual and reproductive health services, promote the sustainability of California’s reproductive health provider safety net, and benefit individuals enrolled in Medi-Cal and other individuals who currently face barriers to such access.​​ 

Seminario web informativo sobre la detección y la transición de las herramientas de atención​​ 

On March 29, from 3 to 4 p.m., DHCS will hold a Screening and Transition of Care Tools webinar (advance registration required) to discuss the Adult and Youth Screening and Transition of Care Tools for Medi-Cal Mental Health Services, which went live on January 1, 2023, as part of California Advancing and Innovating Medi-Cal (CalAIM). This initiative is focused on implementing statewide screening and transition of care tools for both adults and individuals under 21 years old for use by Medi-Cal MCPs and county mental health plans. The webinar will include an overview of the purpose of the initiative, a discussion on notable requirements and case examples, and responses to frequently asked questions. For more information, please visit the Screening and Transition of Care Tools webpage.​​ 

Seminario web público mensual de la Iniciativa de Salud Conductual para Niños y Jóvenes (CYBHI): marzo de 2023​​ 

On March 29, from 3 to 4 p.m., DHCS will virtually host a webinar (advance registration required) to keep stakeholders apprised of DHCS’ progress in implementing various workstreams for CYBHI. Key attendees include, but are not limited to, youth, parents, family members, behavioral health providers, Medi-Cal MCPs, county behavioral health departments, and commercial health plans, as well as educational and other cross-sector partners.​​ 

Reunión del grupo de trabajo de las partes interesadas de las doulas​​ 

El 30 de marzo, de 12 a 2 p.m., DHCS organizará la primera reunión pública virtual del grupo de trabajo de partes interesadas sobre los servicios de doula. La SB 65 requiere que el DHCS convoque a un grupo de trabajo para examinar la implementación del beneficio de doula en Medi-Cal. El grupo de trabajo discutirá formas de garantizar que los servicios de doula estén disponibles para los miembros de Medi-Cal, considerará formas de minimizar las barreras y los retrasos en los pagos a las doulas, y recomendará esfuerzos de divulgación para que los miembros estén al tanto de los servicios de doula disponibles. El enlace de registro de la reunión estará disponible en la página web de la doula a partir del 24 de marzo.​​ 

Seminario web de asistencia técnica de CYBHI RFA​​ 

On March 30, from 1 to 2 p.m., DHCS will virtually host a public CYBHI webinar (advance registration required) on behalf of the Evidence-Based Practices (EBP) and Community-Defined Evidence Practices (CDEP) grants program. This webinar will focus on the “Round Two: Trauma-Informed Programs and Practices” RFA. DHCS will provide technical assistance by sharing responses to frequently asked questions received based on themes. During the webinars, DHCS will not address any live questions. Please email questions related to the Round Two RFA to CYBHI@dhcs.ca.gov. DHCS will post the FAQs to the CYBHI EBP/CDEP grants webpage by March 17.​​ 

Por si te lo perdiste​​ 

California otorga $21.6 millones para abordar la crisis de opioides​​ 

On March 13, DHCS awarded $12 million to 44 programs through the California Youth Opioid Response project, and $9.6 million to 28 entities through the Low-Barrier Opioid Treatment at Syringe Services Programs project. This is the latest investment in a running total of more than half a billion dollars to help prevent opioid overuse and addiction, address opioid use disorders safely and effectively, and reduce overdose deaths.​​ 

DHCS proporciona actualización sobre la plataforma de servicios virtuales de salud conductual para niños y jóvenes​​ 

On March 15, DHCS confirmed it will launch the Behavioral Health Virtual Services Platform, a new technology-enabled services solution for all children, youth, and families in California, in January 2024. The platform is part of Governor Newsom’s Master Plan for Kids’ Mental Health and CYBHI. For more information, please visit the CYBHI webpage.​​ 

Manifestación de la Sección 1115 de Acceso a la Salud Reproductiva de California​​ 

On March 16, DHCS launched 30-day public and Tribal public comment periods to solicit feedback on a proposed CalRHAD Medicaid Section 1115 demonstration. DHCS is seeking approval from CMS to provide competitive grants to reproductive health providers to enhance capacity and access to sexual and reproductive health services, promote the sustainability of California’s reproductive health provider safety net, and benefit individuals enrolled in Medi-Cal and other individuals who currently face barriers to such access.​​ 

Additional information about the CalRHAD application is available on the CalRHAD webpage.​​