November 10, 2023 – Stakeholder News
Principales noticias
Gestión de la Atención Mejorada (ECM) para Niños y Jóvenes Poblaciones de Enfoque (POF) Destacado
On November 3, DHCS published the ECM for Children and Youth POF Spotlight, which is designed to help contracted and prospective ECM providers serving children and youth develop and enhance their ECM models. It is also intended to support provider organizations that are considering if ECM for children and youth is right for them. The new resource outlines key ECM policies for the children and youth POFs, including areas where plans can leverage presumptive authorization; member scenarios that illustrate how to deliver ECM for the children and youth POFs, with examples of how Community Supports can be integrated to best serve children, youth, and caregivers; and guidance on how prospective providers can get started, with a collection of the key resources and funding opportunities.
DHCS is committed to providing technical assistance and support to California’s growing network of ECM providers. This is the first in a series of ECM spotlights that DHCS plans to release over the coming months to support stakeholders seeking more details on how providers tailor ECM to meet the needs of different POFs. For more information, visit the ECM and Community Supports webpage.
Program Actualizaciones
Actualizaciones sobre Medi-Cal y Cuidado de Crianza
DHCS developed a resource to provide updates on foster care youth in Medi-Cal. The resource covers changes to managed care for the child welfare population in 2024, Enhanced Care Management and Community Supports transition policies, the 2024 Medi-Cal managed care plan (MCP) contract and memorandum of understanding requirements, and Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment child and youth components.
Actualizaciones de servicios de doula disponibles en línea
El 3 de noviembre, el DHCS actualizó la página web de los Servicios de Doula como un beneficio de Medi-Cal. La página web actualizada incluye recursos útiles para los miembros de Medi-Cal y los proveedores de doula, incluida la recomendación permanente recientemente emitida para los servicios de doula por la directora médica del DHCS, la Dra. Karen Mark. La recomendación permanente cumple con el requisito federal de una recomendación para los servicios de doula como un servicio preventivo.
Las actualizaciones de la página web también incluyen nuevas preguntas frecuentes para doulas y miembros de Medi-Cal, el número total de solicitudes de proveedores de doulas aprobados y proveedores individuales inscritos, e información sobre evidencia que respalda los beneficios de los servicios de doula para los resultados maternos y de parto. Envíe por correo electrónico cualquier pregunta sobre los servicios de doula a DoulaBenefit@dhcs.ca.gov.
Únete a nuestro equipo
¡DHCS está contratando! DHCS tiene oportunidades para:
- Chief of the Financial Management Division within Fiscal (final filing date (FFD) is November 15). This executive role develops policies and procedures to ensure fiscal integrity, transparency, and accountability of approximately $150 billion in annual state and federal funding for DHCS.
- Behavioral Health Policy Medical Consultant II within Behavioral Health (FFD is November 27). This position provides clinical expertise and strategic advice to DHCS Behavioral Health leadership on the development and implementation of policy and initiatives designed to strengthen behavioral health care access, quality, and service delivery.
- Senior Assistant Chief Counsel for Fiscal and Financing within the Office of Legal Services (FFD is November 28). This position is responsible for complex legal counsel and litigation strategy formulation regarding DHCS fiscal, financial management, and health care policy.
- Asesor Jurídico Principal Adjunto Senior para Sistemas de Prestación de Atención Médica dentro de la Oficina de Servicios Legales (FFD es el 30 de noviembre). Este puesto es responsable de la asesoría legal compleja y la formulación de estrategias de litigio con respecto a varios aspectos del sistema de prestación de atención médica.
DHCS is also hiring for our human resources, auditing, health policy, and information technology teams. For more information, please visit the CalCareers website.
Próximas reuniones de partes interesadas y seminarios web
Mantenga a su comunidad cubierta: Seminario web sobre escuelas y familias
El 16 de noviembre, de 2 a 3 p.m., DHCS llevará a cabo un seminario web sobre Mantenga su comunidad cubierta: escuelas y familias (se requiere inscripción anticipada). El seminario web proporcionará a los socios escolares información importante para ayudar a los estudiantes y sus familias a renovar la cobertura de Medi-Cal. El seminario web también destacará los recursos de divulgación disponibles y las mejores prácticas para involucrar a las familias con niños en edad escolar.
Seminario web sobre los requisitos y procedimientos de inscripción en Medi-Cal para CBO y LHJ
El 17 de noviembre, de 10 a 11:30 a.m., el DHCS llevará a cabo una audiencia pública de las partes interesadas a través de un seminario web (se requiere inscripción anticipada) para discutir el boletín de proveedores regulatorios sobre los requisitos y procedimientos de inscripción en Medi-Cal para organizaciones comunitarias (CBO) y proveedores de jurisdicciones de salud locales (LHJ) que ofrecen servicios de trabajadores de salud comunitarios y/o servicios preventivos para el asma. A partir del 9de enero de 2024, los proveedores de CBO y LHJ que soliciten inscribirse en el programa de pago por servicio de Medi-Cal pueden presentar su solicitud a través del portal de inscripción en línea de Solicitud y Validación de Proveedores para la Inscripción (PAVE).
Se pueden enviar comentarios, preguntas o sugerencias por escrito durante la audiencia en el chat del seminario web. Para aquellos que no puedan asistir, los comentarios por escrito deben enviarse antes de las 5 p.m. del 17 de noviembre para ser considerados para su publicación. Al enviar comentarios por escrito, asegúrese de que el comentarista y la organización/asociación representada estén identificados en los comentarios. Los comentarios por escrito deben enviarse a DHCSPEDStakeholder@dhcs.ca.gov. Con base en los comentarios públicos recibidos, el DHCS publicará el boletín final en los sitios web de Medi-Cal y DHCS .
Seminario web sobre facturación y pago del Centro de Cuidados Intermedios para Personas con Discapacidades del Desarrollo (ICF/DD) de CalAIM
On November 17 at 1 p.m., DHCS will host the fourth in a series of educational webinars on the California Advancing and Innovating Medi-Cal (CalAIM) ICF/DD carve-in (advance registration required). These webinars outline changes to the ICF/DD carve-in policy requirements. Starting on January 1, 2024, all Medi-Cal MCPs will be required to cover and coordinate institutional long-term care for members residing in an ICF/DD. The webinar series will feature several topics, including ICF/DD carve-in 101, directed payment policy and payment requirements, the per diem rate, accommodation code changes, and best practices for billing and payment. ICF/DD home, Regional Center, and Medi-Cal managed care representatives are encouraged to attend. All webinars are open to the public.
If there are specific questions you would like addressed during the webinar, please submit them in advance using this registration form or by emailing them to LTCtransition@dhcs.ca.gov. Webinar materials, including recordings, and additional details about upcoming webinars are posted on the CalAIM ICF/DD Long-Term Care Carve-In webpage.
Seminario web sobre la reforma del financiamiento de los centros de enfermería
On November 17, from 3 p.m. to 4 p.m., DHCS will hold a virtual stakeholder webinar (advance registration required) to discuss the development of the Skilled Nursing Facility Workforce Standards Program, Accountability Sanctions Program, and Workforce & Quality Incentive Program (WQIP) authorized by Assembly Bill 186 (Chapter 46, Statutes of 2022). This meeting will also provide an opportunity for stakeholder input. Additional information is posted on DHCS’ Nursing Facility Financing Reform (AB 186) webpage.
Seminario web del Programa de Cobertura de Audífonos para Niños (HACCP) para familias y socios comunitarios
On November 28, from 11 a.m. to 12 p.m., DHCS will host a HACCP webinar (advance registration required) to share guidance with families and communities about applying for hearing aid coverage and helping children to maximize their HACCP benefits once enrolled. DHCS welcomes newly interested families, as well as families currently participating in HACCP, and community partners supporting families and children to join this webinar for program updates, tips, and a question-and-answer session. For more information, please visit www.dhcs.ca.gov/haccp.
Seminario web de HACCP para proveedores médicos y profesionales de la audición
On December 19, from 12 to 1 p.m., DHCS will host a HACCP webinar (advance registration required) to share information with providers to help pediatric patients and their families maximize HACCP benefits. The training session will address program requirements for families to apply for coverage and the claims submission process for audiologists, otolaryngologists, physicians, and their office staff. For more information, please visit www.dhcs.ca.gov/haccp.
Seminario web sobre la eliminación de activos de Medi-Cal
El 29 de noviembre, de 1:30 a 2:30 p.m., DHCS llevará a cabo un seminario web sobre la eliminación de activos para los programas de Medi-Cal de Ingreso Bruto Ajustado Ajustado no Modificado (MAGI), a partir del 1de enero de 2024. Cuando se implemente, esta iniciativa eliminará la prueba de activos para todos los programas que no son MAGI, incluidos los programas de atención a largo plazo y los programas de ahorros de Medicare. El seminario web proporcionará información general sobre la eliminación de activos, la planificación de la implementación, los cambios de procedimiento y los materiales de divulgación. Hay más información disponible en la página web de Cambios en el límite de activos para Medi-Cal que no es MAGI .
Reunión virtual de grupo de trabajo de servicios y apoyos administrados a largo plazo (MLTSS) y de integración dual de CalAIM
On November 30 at 10 a.m., DHCS will virtually host the CalAIM MLTSS and Duals Integration Workgroup meeting (advance registration required). The workgroup serves as a stakeholder collaboration hub for CalAIM MLTSS and integrated care for dual eligible members, and allows stakeholders to provide feedback and share information about policy, operations, and strategy for upcoming changes to Medi-Cal and Medicare.
Agenda topics will include reminders about the 2024 Medi-Cal transitions and noticing timelines, updates on Medi-Medi Plan outreach and the 2024 Dual Eligible Special Needs Plan Policy Guide development, July 2023 duals enrollment data, a spotlight presentation on the CalAIM recuperative care Community Support, and a presentation on the continuous coverage unwinding.
Background materials, transcripts, and video recordings of previous workgroup meetings, along with additional information about the workgroup, are posted on the CalAIM MLTSS and Duals Integration Workgroup webpage. For questions or comments, please email DHCS at info@calduals.org.
Seminario web sobre la expansión de Medi-Cal para adultos
On December 4, from 11 a.m. to 12 p.m., DHCS will host a webinar on the adult expansion of Medi-Cal (advance registration required) for CBOs, MCPs, providers, and other interested stakeholders, including those representing consumers, immigration, health care, legal aid, and immigrant adults. DHCS is implementing this expansion pursuant to Senate Bill 184 (Chapter 47, Statutes of 2022) on January 1, 2024. When implemented, the expansion will provide individuals 26-49 years of age with full scope Medi-Cal benefits, regardless of citizenship or immigration status, if they meet all other Medi-Cal eligibility criteria.
The webinar, which will be live interpreted in Spanish, will provide background information about the expansion, implementation planning, noticing, outreach, and more. Individuals may also submit questions or request to register for the webinar by sending an email to AdultExpansion@dhcs.ca.gov.
Por si te lo perdiste
Demostraciones de la Sección 1115: Enmienda Transitoria de Alquiler de BH-CONNECT y CalAIM
On October 20, DHCS submitted to Centers for Medicare & Medicaid Services (CMS) the new Section 1115 demonstration request, entitled the California Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) demonstration, and the proposed amendment to the CalAIM Section 1115 demonstration related to transitional rent services. Additionally, the federal public comment period will be open for BH-CONNECT and CalAIM transitional rent services from October 27 through November 26, 2023.
Enero 2024 Transición de Medi-Cal MCP
As part of Medi-Cal transformation, some MCPs are changing on January 1, 2024, and approximately 1.2 million members will have new health plan options and/or will need to transition to new MCPs. Changing MCPs will not affect Medi-Cal member coverage or benefits. Members who transition to a new MCP are receiving notices about the transition. DHCS developed several resources to support members, providers, and other stakeholders with the transition, including the Managed Care Plan Transition Member webpage with a county “lookup” tool, links to member notices sent by Medi-Cal about MCP changes, frequently asked questions, and a Contact Us page for members to learn more about health plans and provider choices. There are also transition resources for providers and MCPs and stakeholders. More information about the transition is available in the 2024 Managed Care Plan Transition Policy Guide and Medi-Cal Eligibility Division Information Letter Number I 23-54.