​January 26, 2024 - Stakeholder News

Program Updates

Updated Enhanced Care Management (ECM) and Community Supports Data

On January 29, DHCS will post new ECM and Community Supports data from Medi-Cal managed care plans (MCPs). The new report provides an updated interactive report that enhances the 2022 implementation report by providing detailed state-, county-, and MCP-level data through Quarter 2 2023. The next quarterly update, which will include implementation data for Quarter 3 2023, is planned for release at the end of Quarter 1 2024.

Medi-Cal Renewal Campaign Refresh

In early February, DHCS will refresh messaging for the Medi-Cal renewal campaign. New ads will prepare people for the return of annual Medi-Cal renewals. The ads will run on digital, television, radio, print, and out-of-home platforms. The content will be distributed through existing partnerships with Univision and Telemundo for Spanish-language television and a new partnership with CrossingsTV for Mandarin, Cantonese, Vietnamese, Punjabi, Korean, and Hmong programming. Select videos will also be updated to include voiceovers to increase accessibility and exposure to more audiences, such as the visually impaired and those who cannot read. Voiceover videos will be available in all threshold languages. New awareness and renewal outreach materials will be available on the Keep Your Community Covered resources hub for download and sharing in all 19 threshold languages.

DHCS is also using available data to retarget communities that have lower renewal rates, specifically with high rates of disenrollments due to members not providing requested paperwork or information.

Children and Youth Behavioral Health Initiative (CYBHI) Fee Schedule Guidance

On January 25, DHCS released draft CYBHI fee schedule guidance for public comment. The draft guidance document outlines the preliminary policies and procedures to expand access to school-linked behavioral health services through the statewide multi-payer school-linked fee schedule (CYBHI fee schedule) and includes guidance for Local Educational Agencies, designated practitioners, Medi-Cal MCPs, and other insurers.

DHCS is accepting feedback and public comment until February 7 at 5 p.m. Feedback and questions can be submitted to DHCS.SBS@dhcs.ca.gov. For more information, please visit the CYBHI webpage.

Comprehensive Perinatal Services Program (CPSP) Services Billing Expansion

On February 1, DHCS will implement necessary systems changes to allow licensed midwives who are enrolled as CPSP providers with the California Department of Public Health (CDPH) to bill for CPSP services provided to Medi-Cal fee-for-service (FFS) members. If you have questions about CPSP enrollment through CDPH, please email CPSPProviderEnrollment@cdph.ca.gov.

Join Our Team

DHCS is hiring:

• Chief of Capitated Rates Development Division within Health Care Financing to serve as the principal policymaker for all rate-setting activities to ensure high-quality and cost-efficient health care through DHCS' contracted Medi-Cal MCPs. (Final filing date is January 30)

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

Public Hearing: Continuous Coverage for Children Amendment to the CalAIM Demonstration

On January 29, from 1 to 2 p.m., DHCS will host a public hearing (advance registration required) to solicit stakeholder comments on a proposed amendment to the California Advancing and Innovating Medi-Cal (CalAIM) Section 1115 demonstration related to continuous coverage for children.

DHCS is seeking approval from the Centers for Medicare & Medicaid Services (CMS) to include expenditure authority under Section 1115(a)(2) to receive federal matching funds to provide continuous coverage for children through the end of the month in which their 5th birthday falls, regardless of when they first enroll in Medi-Cal or the Children's Health Insurance Program and any changes in circumstances that would otherwise cause a loss of eligibility. Implementation of this policy is contingent upon a state determination of available General Fund resources in 2024-2025 and subsequent fiscal years and CMS approval. Additional information is available on the DHCS CalAIM 1115 Demonstration and 1915(b) Waiver webpage.

Doula Stakeholder Implementation Workgroup Meeting

On January 31, from 2 to 4 p.m., DHCS will host the Doula Stakeholder Implementation Workgroup meeting to examine implementation of the Medi-Cal doula benefit, in accordance with Senate Bill 65 (Chapter 449, Statutes of 2021) and section 14132.24 of the Welfare and Institutions Code.

The meeting will be held via Zoom, with an in-person option at 1700 K Street, Room 1014, Sacramento, CA 95811. The meeting is open to the public. The link to attend the meeting virtually and the agenda are posted on the Doula Services as a Medi-Cal Benefit webpage. The workgroup will discuss how to ensure doula services are available to Medi-Cal members and make recommendations on outreach efforts. Please email DoulaBenefit@dhcs.ca.gov with any questions.

Consumer-Focused Stakeholder Workgroup (CFSW) Virtual Meeting

On February 2, beginning at 10 a.m., DHCS will hold the next CFSW meeting. The agenda, meeting materials, and instructions on how to join the meeting will be posted on the DHCS CFSW webpage by noon on January 31.

ECM for Birth Equity Populations Webinar

On February 2, from 1:30 to 3 p.m., DHCS will host a webinar on Launching ECM for Birth Equity Populations (advance registration required) to review the vision of ECM for the birth equity population of focus (POF), as well as the early days of implementation. DHCS, in partnership with Medi-Cal MCPs and providers across the state, launched ECM for the birth equity POF on January 1. This webinar will provide an overview of the design and operational guidance for the birth equity POF; give provider perspectives on how they prepared for the launch of ECM for the birth equity POF and tailored approaches to providing ECM; and offer guidance to MCPs, counties, and providers on contracting and preparing to deliver the ECM benefit to address known disparities in health and birth outcomes in racial and ethnic groups with high maternal morbidity and mortality rates.  

The webinar is open to all, but will be of special interest to MCPs and providers working with birth equity populations, including counties and community-based organizations. Providers interested in learning more about ECM for the birth equity POF or about referring members may also attend. Participants are invited to submit questions by January 29 to CalAIMECMILOS@dhcs.ca.gov. Attendees will be able to ask questions during the webinar. 

Hearing Aid Coverage for Children Program (HACCP) Webinar for Medical Providers and Hearing Professionals

On February 13, 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 outline program requirements for families to apply for coverage. It will also outline the claims submission process for audiologists, otolaryngologists, physicians, and their office staff. For more information, please visit www.dhcs.ca.gov/haccp.

In Case You Missed It

Medi-Cal Targeted Rate Increases (TRI)

Pursuant to Assembly Bill (AB) 118 (Chapter 42, Statutes of 2023), DHCS published, as part of the proposed 2024–25 Governor's Budget, a plan for targeted increases to Medi-Cal payments or other investments, effective in 2025, across primary care, maternal care, behavioral health care, specialty care, women's health services, public hospital services, community and hospital outpatient services, emergency services, and other domains. The proposed investments will be supported with funding from the Managed Care Organization (MCO) Tax, authorized by AB 119 (Chapter 13 , Statutes of 2023), and are designed to advance access, quality, and equity for Medi-Cal members and promote provider participation in the Medi-Cal program. These proposed investments are subject to obtaining all necessary legislative and federal approvals, as applicable. For more information, please visit the Medi-Cal Targeted Provider Rate Increases and Investments webpage and view the Medi-Cal TRI policy paper and MCO Tax-funded investments.

Continuous Coverage Unwinding Data 90-Day Refresh

On December 29, DHCS submitted to CMS a mandated update to the federal unwinding data for June to August 2023. Individuals who are discontinued from Medi-Cal for procedural reasons have 90 days to submit necessary information to counties to complete their renewal. Due to the required timing to submit unwinding data, previous submissions did not include individuals who had their Medi-Cal reinstated during the 90-day reconsideration period. This update includes a refresh of the previously submitted data, including outcomes for individuals in the 90-day reconsideration period.