Cov Ntaub Ntawv Sib Tham ntawm Pawg Neeg Saib Xyuas Kev Pab Tswv Yim ntawm Medi-Cal
Hnub Tim: Lub Rau Hli 3, 2026
Lub Sijhawm: 5:30 tsaus ntuj - 7:30 tsaus ntuj PDT
Hom Kev Sib Tham: Virtual los ntawm Microsoft Teams
Cov Tswv Cuab Tuaj Koom: 12 Tus Tswv Cuab MMAC Tuaj Koom
DHCS Staff and Partners: Michelle Baass, Director; Tracy Arnold, Assistant Director; Tyler Sadwith, State Medicaid Director; Krissi Khokhobashvili, Deputy Director, Office of Communications; Yingjia Huang, Deputy Director, Health Care Benefits and Eligibility; Tyra Taylor, Assistant Deputy Director, Program Operations; Paula Wilhelm, Deputy Director, Behavioral Health; Michelle Retke, Chief, Managed Care Operations; Brian Hansen, Policy Advisor to the Directorate; Eduardo Lozano, Stakeholder and Community Engagement Analyst; Maria Romero-Mora, Stakeholder and Community Engagement Analyst; Kiran Poonia, Stakeholder and Community Engagement Analyst; Isabel Flores, Stakeholder and Community Engagement Analyst; Evelyne Kane, Associate Director of Community Engagement and Capacity Building, Camden Coalition; Marisol Caban, Associate Director of Community Engagement and Capacity Building, Camden Coalition; Daisha Bonhomme, Community Catalyst.
Cov Lus Qhia Ntxiv: Thov saib cov lus nthuav qhia PowerPoint uas siv thaum lub rooj sib tham kom paub ntxiv txog cov ntsiab lus thiab cov ntsiab lus.
Agenda:
| Sijhawm | Cov ntsiab lus |
|---|---|
| 5:30 – 6:00 | Txais Tos thiab Kev Taw Qhia |
| 6:00 – 7:00 | DHCS Presentation: Transition of Unsatisfactory Immigration Status Medi-Cal Members to Fee-for- Service |
| 7:00 – 7:25 | Kev Sib Tham Hauv Pawg thiab Cov Lus Qhia ntawm Cov Tswv Cuab |
| 7:25 – 7:30 | Cov Lus Xaus thiab Cov Kauj Ruam Tom Ntej |
Txais Tos thiab Kev Taw Qhia
Hom Kev Ua: Cov Ntaub Ntawv
Tus Thawj Coj: Maria Romero-Mora
Cov Ncauj Lus Sib Tham:
- Cov tswv cuab ntawm MMAC tau txais tos, thiab kev ncaj ncees ntawm cov lus thiab cov qauv hauv zej zog tau raug tshuaj xyuas kom ceeb toom cov neeg koom nrog txog kev koom tes thiab kev koom tes.
- Cov neeg koom nrog tau raug hais kom qhia txog tej kev tsis sib haum xeeb; tsis muaj leej twg tau txheeb xyuas.
- DHCS tau txais tos ob tug tswv cuab tshiab rau MMAC thiab caw txhua tus tswv cuab ntawm DHCS thiab MMAC los qhia lawv tus kheej.
DHCS Presentation: Transition of Unsatisfactory Immigration Status Medi-Cal Members to Fee-for-Service
Hom Kev Ua: Cov Ntaub Ntawv
Presenter: Yingjia Huang
Cov Ncauj Lus Sib Tham:
- DHCS tau nthuav tawm txog kev hloov pauv ntawm Cov Tswv Cuab Uas Muaj Xwm Txheej Tsis Txaus Siab (UIS) mus rau Tus Nqi Pabcuam (FFS).
- Cov ntsiab lus tseem ceeb suav nrog:
- Thaum Lub Ib Hlis Ntuj hnub tim 1, 2027, cov tswv cuab Medi-Cal uas muaj Qhov Xwm Txheej Nkag Tebchaws Tsis Txaus Siab yuav raug tsiv tawm ntawm Medi-Cal managed care mus rau Fee-For-Service.
- Qhov kev hloov pauv no yog qhov yuav tsum tau ua los ntawm cov lus qhia tshiab ntawm tsoomfwv uas tau muab los ntawm Lub Chaw rau Medicare thiab Medicaid Services thiab tau piav qhia nyob rau hauv Tsab Ntawv Qhia Txog Tus Thawj Coj Medicaid ntawm Lub Xeev.
- Cov tswv cuab Medi-Cal uas muaj Txoj Cai Nkag Tebchaws Tsis Txaus Siab suav nrog:
- Txhua tus neeg tsiv teb tsaws chaw uas tsis muaj ntaub ntawv pov thawj, suav nrog cov menyuam yaus thiab cov poj niam cev xeeb tub.
- Cov neeg nyob ruaj khov raws li txoj cai (Cov Neeg Tuav Daim Npav Ntsuab) uas tau nyob hauv Tebchaws Meskas tsawg dua tsib xyoos.
- Cov neeg tsis yog pej xeem nyob hauv Tebchaws Meskas uas muaj cai nyob ruaj khov raws li xim ntawm txoj cai (PRUCOL) uas paub thiab tso cai los ntawm cov tub ceev xwm nkag tebchaws (xws li cov neeg uas tseem tab tom tos kev tiv thaiv lossis raug ncua kev xa tawm) thaum lawv tos kom tau txais daim ntawv pov thawj zaum kawg.
- Cov pej xeem uas tsis raug cuam tshuam suav nrog:
- Cov pej xeem Asmeskas
- Cov neeg nyob ruaj khov raws li txoj cai (Cov Neeg Tuav Daim Npav Ntsuab) uas tau nyob hauv Tebchaws Meskas tau tsib xyoos lossis ntev dua.
- Nyob rau hauv Medi-Cal uas them tus nqi rau kev pabcuam:
- Cov txiaj ntsig tsis raug tswj hwm los ntawm txoj kev npaj kho mob Medi-Cal; tsis muaj pab pawg neeg saib xyuas lossis "tsev kho mob."
- Cov tswv cuab yuav tsum nrhiav thiab txheeb xyuas cov chaw muab kev pab Medi-Cal uas tab tom txais cov neeg mob tshiab.
- Cov tswv cuab yuav tsum nqa lawv daim npav Medi-Cal Beneficiary Identification Card uas tseem hu ua "BIC card."
- Cov tswv cuab yuav plam qee yam kev pabcuam thiab cov txiaj ntsig, xws li Kev Txhawb Nqa Hauv Zej Zog thiab Kev Tswj Xyuas Kev Kho Mob Zoo Dua, uas tsuas yog muaj los ntawm kev tswj hwm kev saib xyuas xwb.
- DHCS cog lus tias yuav ua haujlwm nrog cov tswv cuab Medi-Cal, cov phiaj xwm kev saib xyuas uas tau tswj hwm, cov chaw muab kev pabcuam, thiab cov neeg koom tes hauv zej zog los txhawb cov tswv cuab thoob plaws hauv kev hloov pauv.
Kev Sib Tham Ua Pab Pawg
Hom Kev Ua: Kev Sib Tham Hauv Chav Breakout
Cov Ncauj Lus Sib Tham:
Koj qhov kev xav lossis kev txhawj xeeb tam sim ntawd yog dab tsi?
- Cov tswv cuab ntawm MMAC tau hais txog kev txhawj xeeb txog qhov kev hloov pauv no yuav raug pom los ntawm cov zej zog tsiv teb tsaws chaw hauv cov ntsiab lus ntawm ntau lwm yam teeb meem (piv txwv li, kev tswj hwm kev nkag tebchaws hauv tebchaws), tsim kev tsis meej pem, kev tsis ruaj khov, thiab kev puas tsuaj rau cov zej zog uas twb muaj kev phom sij lawm.
- Cov tswv cuab ntawm MMAC tau hais txog kev txhawj xeeb txog cov teeb meem rau kev nkag mus rau kev saib xyuas thiab nrhiav cov neeg muab kev pabcuam uas lees txais Fee-for-Service tshwj xeeb tshaj yog nyob rau hauv thaj chaw nyob deb nroog thiab thaj chaw muaj kev pheej hmoo siab uas tam sim no tsis muaj cov neeg muab kev pabcuam uas tau sau npe.
- Muaj ib txhia nug txog cov nqi uas cuam tshuam nrog Fee-for-Service thiab cov nqi no yuav ua li cas txwv lossis ua rau tib neeg tsis xav nrhiav lossis nkag mus rau kev kho mob.
- Cov tswv cuab ntawm MMAC tau hais tias txhua tus neeg, suav nrog cov neeg tsiv teb tsaws chaw, yuav tsum tau txais kev kho mob, thiab tias kev tshem tawm kev kho mob yog qhov tsis ncaj ncees thiab ua rau muaj kev phom sij.
- Cov tswv cuab ntawm MMAC txhawj xeeb txog seb cov kev hloov pauv no yuav ua rau muaj kev cuam tshuam dav dua rau lub cev kho mob, uas yuav cuam tshuam rau kev kho mob tshwj xeeb, lwm yam kev pabcuam, thiab cov chaw kho mob hauv zej zog.
- Ib tug tswv cuab ntawm MMAC tau nug tias qhov kev hloov pauv no yuav cuam tshuam li cas rau cov tib neeg uas muaj Deferred Action for Childhood Arrivals (DACA) thiab lwm tus uas tsis muaj feem cuam tshuam nrog visa.
How can we support Medi-Cal members during this transition
- Qhia cov neeg xa xov hauv zej zog uas lawv ntseeg siab, xws li cov kws tshwj xeeb txhawb nqa cov phooj ywg, cov neeg ua haujlwm hauv zej zog, cov neeg txhawb nqa, thiab cov neeg sawv cev, los qhia cov tswv cuab txog kev hloov pauv thiab txhawb nqa lawv los ntawm kev koom tes ib leeg.
- Xyuas kom tseeb tias cov npe ntawm cov chaw muab kev pab uas lees txais Medi-Cal uas them nqi rau kev pabcuam yog cov tshiab thiab yooj yim rau cov tswv cuab uas cuam tshuam.
- Piav qhia thiab piav qhia meej txog lo lus "fee-for-service" hauv cov ntaub ntawv sib txuas lus vim tias nws tuaj yeem ua rau nkag siab yuam kev, vim nws zoo li cov tswv cuab yuav tsum them rau txhua qhov kev pabcuam kho mob tau txais.
- Sau cov ntaub ntawv (piv txwv li, cov ntaub ntawv thov kev pab, kev mus ntsib chav kho mob thaum muaj xwm txheej ceev thiab lwm yam) thiab koom nrog cov tswv cuab Medi-Cal uas cuam tshuam (piv txwv li, cov pab pawg tsom xam, cov ntawv soj ntsuam tawm tswv yim) thaum lub sijhawm thiab tom qab kev hloov pauv kom nkag siab txog cov teebmeem hauv lub ntiaj teb tiag tiag, cov teeb meem, thiab cov cib fim los txhim kho kev txhawb nqa.
- Muab kev txhawb nqa thiab cov ntaub ntawv ntxiv rau cov neeg uas yuav tsum hloov cov chaw muab khoom siv kho mob ntev vim yog hloov mus rau qhov them nqi rau kev pabcuam, vim tias cov kev hloov pauv no tuaj yeem nyuaj dua thiab nyuaj dua li kev hloov cov chaw muab kev kho mob.
- Siv cov kev qhia txog kev raug mob hauv kev sib txuas lus thiab kev pabcuam txhawb nqa kom lees paub qhov kev ntshai, kev tsis ntseeg siab, thiab cov teeb meem uas cov zej zog tsiv teb tsaws chaw tau ntsib.
- Kev sib txuas lus uas xa los ntawm cov lus ntawv yuav tsum muaj kev hu kom ua haujlwm meej, ua ke nrog cov ntawv xa tuaj, thiab txuas mus rau cov ntaub ntawv uas tuaj yeem txheeb xyuas tau lwm qhov kom tsis txhob raug pom tias yog kev dag ntxias.
- Muab kev sib txuas lus kom ntxaws thiab raws li tus kheej xav tau, suav nrog cov hau kev los xyuas tus neeg tus kheej qhov xwm txheej thiab cov kauj ruam tom ntej uas yuav tsum tau ua.
- Tso cai rau cov tswv cuab xaiv lawv qhov kev nyiam sib txuas lus (email, text, lossis xa ntawv).
Cov Lus Qhia ntawm Cov Tswv Cuab
Hom Kev Ua: Cov Ntaub Ntawv
Tus Thawj Coj: Maria Romero-Mora
Cov Ncauj Lus Sib Tham:
- Ib tug tswv cuab ntawm MMAC tau hais tias kev txhawb nqa cov neeg ua haujlwm kev noj qab haus huv thiab kev pabcuam tib neeg yog qhov tseem ceeb los ntawm ntau yam kev hloov pauv no vim tias cov haujlwm thiab cov luag haujlwm ntxiv tuaj yeem cuam tshuam rau lawv txoj kev noj qab haus huv thiab lub peev xwm ua tiav lawv txoj haujlwm.
- Ib tug tswv cuab ntawm MMAC tau hais txog qhov tseem ceeb ntawm kev sib txuas lus rau cov tswv cuab uas raug kev txom nyem tias txawm hais tias kev kho hniav niaj hnub tsis raug them los ntawm Fee-for-Service, kev them nqi kho hniav thaum muaj xwm txheej ceev tseem raug them.
- Ib tug tswv cuab ntawm MMAC tau hais tias nws yog ib qho tseem ceeb uas yuav tsum tau hais tias Medi-Cal them rau kev mus ntsib kws kho mob menyuam yaus.
Cov Lus Xaus
Hom Kev Ua: Cov Ntaub Ntawv
Presenter: Michelle Baass
Cov Ncauj Lus Sib Tham:
- Michelle Baass thanked members for their engagement and for being part of this collaborative space with Team DHCS.
- Cov tswv cuab tau txhawb kom txuas ntxiv mus saib nplooj ntawv Medi-Cal Changes kom nrhiav tau cov ntaub ntawv hais txog cov kev hloov tshiab tshiab rau qhov kev pab cuam Medi-Cal thiab txuas nrog cov peev txheej ntxiv thiab Medi-Cal Coverage Ambassadors.
Kev Tshem Tawm Lub Rooj Sib Tham
Lub Npe Tus Neeg Uas Tau Ncua Lub Rooj Sib Tham: Michelle Baass
Lub Sijhawm Kawg: 7:30 teev tsaus ntuj PDT