Volver a las enmiendas propuestas al plan estatal por año

These proposed State Plan Amendments (SPAs) would change statewide methods and standards for Medicaid payment rates. All of these SPAs require a Public Notice prior to submission to the Centers for Medicare & Medicaid Services (CMS). All 2024 Public Notice announcements will be published on this webpage when they are available. Once these SPAs are submitted to or approved by CMS they are also posted in the pending or approved SPAs pages. For any questions or concerns, please contact PublicInput@dhcs.ca.gov.

• 24-0002 Proposes to extend the Public Provider Ground Emergency Medical Transport Intergovernmental Transfer Program in calendar year 2024. (Released December 29, 2023)
• 24-0003 y SPA Pages Propone incluir los Centros de Tratamiento Residencial Psiquiátrico (PRTF) como un entorno donde se pueden proporcionar servicios psiquiátricos para pacientes hospitalizados a beneficiarios menores de 22 años. Además, este SPA incluirá una metodología de reembolso por los servicios psiquiátricos para pacientes hospitalizados prestados en los PRTF. (Publicado el 20de diciembre de 2023)
• 24-0004 Propone renovar y modificar la metodología de reembolso para las instalaciones independientes de enfermería especializada/subaguda de nivel B e implementar el Program de Estándares de la Fuerza Laboral. (Publicado el 28de diciembre de 2023)
  • Note: The due date for comments is Monday, January 29, 2024.
• 24-0005 y SPA Pages Propone agregar hogares grupales para niños con necesidades especiales de atención médica como un nuevo proveedor de servicios de arreglos de vivienda comunitaria y agregar un método de prestación de servicios dirigido por el participante para servicios de apoyo autodirigido. (Publicado el 6de febrero de 2024)
• 24-0006 y SPA Pages Propone implementar la próxima ronda de ajustes de reforma de tarifas, a partir del 1de julio de 2024, como se requiere actualmente en la sección 4519.10 del Código de Bienestar e Instituciones. El Presupuesto del Gobernador 2024-25 propone devolver la implementación completa de la reforma de tarifas, incluida esta próxima ronda de ajustes, a la fecha original de julio de 1 2025 de la fecha acelerada de julio de 1de julio de 2024. El Departamento de Servicios de Desarrollo de California (DDS, por sus siglas en inglés) continúa preparándose administrativamente para la implementación completa de la reforma de tarifas, sujeto al acuerdo presupuestario final 2024-25. (Publicado el 6de febrero de 2024)
• 24-0007 Proposes to update the Alternative Benefit Plan (ABP) to add PRTFs as settings where inpatient psychiatric services can be provided to Medi-Cal members under 21 years of age. This SPA also seeks to update the ABP to allow Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) to bill for encounters by Licensed Professional Clinical Counselors (LPCCs) services, and Associate Professional Clinical Counselors (APCCs). (Released March 14, 2024)
• 24-0009 Proposes the Medi-Cal program to enter into value-based supplemental drug rebate agreements with manufacturers and to seek approval for an associated Value-Based Supplemental Drug Rebate Agreement template. (Released February 21, 2024)
• 24-0011 Propone que el estado celebre un acuerdo de compra de Medicare Part A con CMS. (Publicado el 25de septiembre de 2024)
• 24-0013 y Páginas SPA Propone extender y actualizar los montos de pago para el reembolso suplementario para Hospitales Privados Calificados Program hasta el 30 de junio de 2025. (Publicado el 30de mayo de 2024)  
• 24-0014 y SPA Pages Propone extender el reembolso suplementario para Program de Hospitales Públicos No Designados Calificados hasta junio 30, 2025. (Publicado el 30de mayo de 2024)
• 24-0015 Proposes to add APCC services as covered Medi-Cal services for FQPHCs, RHCs, and Tribal FQHCs. (Released March 12, 2024)
• 24-0016 Proposes to add Community Health Workers as a covered dental benefit to the Medi-Cal program. (Released March 6, 2024) 
• 24-0017 and SPA Pages Proposes to update the Medi-Cal reimbursement methodology for Diagnosis Related Group Payments for State Fiscal Year 2024-25. (Released May 30, 2024)
  • 24-0017 Addendum Proposes to add additional long-acting reversible contraception codes to the Separately Payable Services, Devices, and Supplies list. (Released June 27, 2024)
• 24-0019 Proposes to decrease the payment cap for supplemental payments for Martin Luther King Jr. – Los Angeles Healthcare Corporation. (Released May 30, 2024)
• 24-0025 Proposes to to renew the Ground Emergency Medical Transportation Quality Assurance Fee program and the reimbursement add-on provided for Medi-Cal ground emergency medical transports, effective for dates of service July 1, 2024 through June 30, 2025. (Released April 5, 2024)
• 24-0026 – Please see the SPA 24-0029 Public Notice Addendum below to find more information.
• 24-0027 Proposes to update Intergovernmental (IGT) funded payments for the Supplemental Reimbursement for Qualified Private Hospitals for State Fiscal Year 2023-24. (Released March 30, 2024)
  • 24-0027 Addendum Proposes revised fiscal estimates. (Released April 25, 2024)
• 24-0028 Proposes amendment to Medi-Cal Home and Community Based Services 1915(i) State Plan for the developmentally disabled. 
• 24-0029 Proposes to revise hospital program eligibility criteria and make associated technical edits to various supplemental reimbursement methodologies. (Released March 29, 2024)
  • 24-0029 Addendum Provides an update for the proposed SPA 24-0026. (Released June 26, 2024)
  • 24-0029 Addendum Proposes to include additional facilities. (Released September 20, 2024)
  • 24-0029 Addendum Provides clarifications on Disproportionate Share Hospital eligibility for cost-based hospitals. (Released September 25, 2024)
• 24-0031 Proposes to make clarifying and technical edits to Behavioral Treatment Services. (Released December 30, 2024)
• 24-0033 and SPA Pages Proposes to add alternative payment methodology for capitated reimbursement of participating federally qualified health centers. (Released June 3, 2024)
• 24-0034 Proposes to increase reimbursement rates for the Prenatal Screening and Newborn Screening Programs. (Released June 21, 2024)
• 24-0035 Proposes to update the eligibility requirements for the Health Insurance Premium Payment (HIPP) program. As currently worded, if a HIPP member does not have an existing policy, has not applied for Medicare benefits, or has the option to enroll in a managed care plan, they are ineligible for HIPP. DHCS seeks to remove these requirements. (Released November 15, 2024)
• 24-0038 Propone ampliar la lista de proveedores que pueden monitorear a los Trabajadores Comunitarios de Salud (CHWs). El DHCS también propuso modificaciones técnicas al ABP para incluir los cambios recientes en los servicios especializados de salud mental y para aclarar la cobertura del tratamiento de salud conductual. (Publicado en septiembre 12 2024)
• 24-0039 Proposes to eliminate the Alternative Payment Methodology for COVID-19 vaccine-only visits to Federally Qualified Health Centers, Rural Health Clinics, and Tribal Health Programs.
• 24-0041 and SPA Pages Proposes to update the Medi-Cal Rehabilitative Mental Health Services, Targeted Case Management, Substance Use Disorder Treatment Services, Expanded Substance Use Disorder Treatment Services, and Medication-Assisted Treatment clinical trainee provider types. (Released June 3, 2024)
  • Note: In Supplement 2 to Attachment 3.1-B p. 11, the definition for “Clinical Trainee” includes individuals who are enrolled in a post-secondary educational degree program to become a “Registered Pharmacists”. The term ‘Registered” was mistakenly included within this definition and should instead state “Pharmacist.”
• 24-0042 Proposes to expand the continuum of Community-Based Services and Evidence-Based Practices available through Medi-Cal Specialty Behavioral Health Delivery Systems. (Released September 13, 2024)
• 24-0044 and SPA Page Proposes to add rates to the fee schedule for Withdrawal Management (WM) Levels 1 and 2 for providers in all DMC-ODS Counties. (Released October 3, 2024)
• 24-0045 and SPA Pages Proposes to extend a time-limited supplemental payment program for qualifying non-hospital 340B community clinics. (Released June 27, 2024)
• 24-0047 Propone actualizar las tarifas de reembolso para los Encuentros Móviles de Intervención en Crisis Basados en la Comunidad. (Publicado el 28de junio de 2024)
• 24-0051 Proposes to add Supported Employment as a covered service under the ABP and to add additional eligibility groups to the ABP. (Released November 13, 2024)
• 24-0052 Propone agregar Servicios Mejorados de CHW como un Servicio de Salud Mental de Rehabilitación, Servicio de Trastorno por Uso de Sustancias (SUD) y Servicio Ampliado de SUD. (Publicado el 13de septiembre de 2024)
• 24-0053 Proposes to add specified hospitals to list of government-operated hospitals receiving cost-based reimbursement for inpatient hospital services. (Released September 27, 2024)
• 24-0054 Propone establecer que, para acuerdos, sentencias y/o indemnizaciones no asignadas, la asignación médica no será superior al 50 por ciento del acuerdo, sentencia y/o indemnización tras deducir los honorarios de abogados y los costos del litigio. (Publicado el 10de diciembre de 2024)