January 5, 2024 - DHCS Stakeholder News
Program Updates
Multipurpose Senior Services Program (MSSP) Waiver Renewal Application – 30-Day Public Comment Period
On January 8, the California Department of Aging (CDA), in partnership with DHCS, will post a draft of the 2024 MSSP waiver renewal application for a 30-day public comment period, prior to submitting the final application to the federal Centers for Medicare & Medicaid Services (CMS) for reauthorization. The MSSP waiver expires on June 30, 2024; CDA intends to renew the waiver for another five-year waiver term beginning on July 1, 2024.
MSSP provides both social and health care management services to help individuals ages 65 and older remain in their own homes and communities. To qualify for MSSP, these individuals must meet the criteria for skilled nursing facility care. MSSP's goal is to prevent or delay institutionalization through ongoing care management, using available community services and resources and purchasing needed services when they are not already available.
The MSSP waiver renewal application will be posted to CDA's website, along with an email address for submitting written feedback. All comments must be received by February 6. CDA invites all interested parties to review the amendments and comment instructions on the CDA webpage.
Please email your questions to MSSPService@aging.ca.gov.
Join Our Team
DHCS is hiring:
- Chief of Capitated Rates Development Division within Health Care Financing serves as the principal policymaker for all rate-setting activities to ensure high-quality and cost-efficient health care through DHCS' contracted Medi-Cal managed care plans (MCP). (Final filing date extended to January 30)
- Chief of Fee-for-Service Rates Development Division within Health Care Financing develops, interprets, and issues policy on Medi-Cal reimbursement methodologies for Medi-Cal fee-for-service (FFS) non-institutional and long-term care services and provider fee programs. (Final filing date extended to January 9)
DHCS is also hiring for our communications, human resources, auditing, health policy, information technology, and other teams. For more information, please visit the CalCareers website.
Upcoming Stakeholder Meetings and Webinars
Population Health Management Updated Transitional Care Services (TCS) Policy Webinar
On January 22, from 11 a.m. to 12 p.m., DHCS will host a webinar to provide an overview of recent updates to the TCS policy (advance registration required), as outlined in the Population Health Management Policy Guide. The revised policy clarifies the requirements for high-risk members by updating the definition of “high-risk groups", reaffirming DHCS' focus on maternity care and populations with behavioral health needs, emphasizing MCP oversight on facility discharge planning processes, and underscoring the importance of member engagement.
The TCS policy for lower-risk members was also updated for 2024 and 2025 to provide member-centered transitional care support with a lighter-touch approach than the model for high-risk members. While the updated lower-risk model removes the single point of contact requirement, it does impose a clear but less staff-heavy requirement for a MCP telephonic team to be available for all transitioning members and requires follow-up with a primary or ambulatory care provider within 30 days of discharge. It also emphasizes existing requirements on hospitals regarding the discharge process. The webinar will offer interested stakeholders the opportunity to learn more and ask questions about these recent updates.
In Case You Missed It
California's Managed Care Organization (MCO) Tax Receives Federal Approval
On January 3, DHCS issued a news release announcing that the State of California received federal approval from CMS for its MCO tax federal waiver application. This approval paves the way for DHCS to move forward with targeted provider rate increases and additional health care system investments that will advance access, quality, and equity in care and services for millions of Medi-Cal members. These rate increases also promote provider participation in the state's Medi-Cal program, helping shore up the health care workforce.
January 2024 Medi-Cal MCP Transition
On January 1, DHCS achieved a significant milestone in its transformation of Medi-Cal with the launch of the new managed care contract and the MCP transition, under which approximately 1.2 million members gained new health plan options and/or transitioned to new MCPs (note: changing MCPs does not affect Medi-Cal member coverage or benefits). To facilitate a smooth transition between MCPs for members, DHCS created Continuity of Care protections that ensure members may keep their providers for up to 12 months and/or continue receiving authorized services.
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 the member notices sent by Medi-Cal about MCP changes, member frequently asked questions, and a Contact Us page for members to learn more health plan changes. 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.
