CalAIM Behavioral Health Initiative Cov lus nug nquag nug
CalAIM Behavioral Health Initiative
Rov qab mus rau CalAIM Homepage
CalAIM yog ib qho kev pib ntau xyoo los ntawm DHCS los txhim kho lub neej zoo thiab kev noj qab haus huv ntawm peb cov pej xeem los ntawm kev siv cov txheej txheem xa khoom dav dav, kev pab cuam thiab kev hloov pauv nyiaj thoob plaws Medi-Cal qhov kev pab cuam.
Rub tawm daim ntawv qhia tseeb txog CalAIM teg num txhawm rau txhim kho Kev Noj Qab Haus Huv
Nyob Txuas
Thov sau npe rau DHCS cov kev pabcuam email rau cov neeg koom nrog kom tau txais cov xov xwm tshiab thiab cov ntaub ntawv ntawm CalAIM txog cov rooj sib tham ntawm cov neeg koom nrog uas yuav los tom ntej. Tiv tauj CalAIM@dhcs.ca.gov.
Cov lus nug nquag
DHCS tseem cog lus tias yuav pab cov neeg koom nrog kev siv CalAIM cov kev pib, uas suav nrog Cov Qauv rau Cov Tswv Cuab Nkag Mus Rau Cov Kev Pabcuam Kev Noj Qab Haus Huv Tshwj Xeeb (SMHS), Kev Xaiv Tus lej Thaum Lub Sijhawm Soj Ntsuam Tshuaj Medi-Cal Lub Txheej Txheem Xa Khoom (DMC-ODS), Kev Tsim Dua Cov Ntaub Ntawv, thiab Tsis Muaj Qhov Rooj Tsis Zoo Rau Txoj Cai Pabcuam Kev Noj Qab Haus Huv. Hauv qab no yog cov npe ntawm cov lus nug nquag nug uas tau sau los ntawm kev pabcuam kev txawj ntse thiab kev sib tham hauv webinars thiab xa mus rau BHCalAIM@dhcs.ca.gov email. DHCS yuav hloov kho daim ntawv teev npe no txhua peb lub hlis.
Nyiaj txiag
Txij li tsev neeg kev puas siab puas ntsws tsis muaj tus neeg mob tam sim no (CPT code 90846) tuaj yeem tshaj tawm hauv Drug Medi-Cal (DMC) Organized Delivery System, nws puas yuav tsum tau tshaj tawm hauv Speciality Mental Health (SMHS) kev xa khoom?
Puas Muaj Kev Pabcuam Ntau Tsev Neeg Psychotherapy (CPT code 90849) tuaj yeem siv los qhia txog kev kho tsev neeg thaum tus tswvcuab tsis nyob hauv DMC-ODS kev xa khoom?
Cov nroog puas tuaj yeem siv HCPCS code H0007 (kev pabcuam cawv thiab/lossis tshuaj; kev cuam tshuam txog teebmeem) los qhia txog kev sib cuag nrog cov khoom ntiag tug uas yog ib feem ntawm kev cuam tshuam kev kub ntxhov hauv DMC-ODS kev xa khoom?
Cov nroog puas tuaj yeem siv HCPCS code H0032 (kev pabcuam kev puas siab puas ntsws tsim los ntawm tus kws kho mob uas tsis yog kws kho mob) los tshaj tawm txog kev sib cuag nrog SMHS?
Cov nroog puas tuaj yeem siv HCPCS code H0034 (kev cob qhia tshuaj thiab kev txhawb nqa) los qhia txog kev tiv thaiv kev tiv thaiv hauv DMC-ODS thiab SMHS kev xa khoom?
Puas yog HCPCS cov lej H0038 thiab H0025 (Peer Support Services) suav nrog kev tiv tauj?
Puas Muaj Kev Txhim Kho thiab Kev Rov Qab Los Puas suav nrog kev sib txuas lus hauv SMHS thiab DMC-ODS cov khoom xa tuaj raws li, thiab cov nroog puas tuaj yeem siv HCPCS code H2017 los piav qhia cov neeg sib cuag?
HCPCS H2021 puas tuaj yeem siv tau (Kev Pabcuam Hauv Zej Zog Hauv Zej Zog) los piav qhia txog kev tiv tauj thaum tus tswvcuab tsis nyob?
Puas Muaj Kev Pabcuam Tus Cwj Pwm Zoo, piav qhia los ntawm HCPCS code H2019, suav nrog kev lav phib xaub rau cov tib neeg uas tsis yog tus tswv cuab ntawm tsev neeg lom neeg?
Puas tuaj yeem qhia txog kev tiv thaiv tus neeg mob sab nraud ntxiv nrog rau Kev Pabcuam Therapeutic Foster Care (TFC)?
Puas yog lub hom phiaj kev tswj xyuas cov ntaub ntawv (HCPCS code T1017) suav nrog kev tiv tauj?
Puas yog tus tswv cuab yuav tsum muaj nyob rau thaum Lub Hom Phiaj Kev Tswj Xyuas Cov Cai (HCPCS code T1017) tau muab?
Lub nroog puas tuaj yeem tshaj tawm H2035 (kev pabcuam cawv thiab / lossis lwm yam kev pabcuam tshuaj) thiab, ntxiv rau, cais qhia txog kev pabcuam nyiaj txiag?
Cov Qauv Rau Cov Tswv Cuab Nkag Mus Rau Cov Kev Pabcuam Kev Noj Qab Haus Huv Tshwj Xeeb (SMHS)
Puas yog kev kuaj mob puas hlwb yuav tsum tau nkag mus rau SMHS?
SMHS tuaj yeem muab tau ntev npaum li cas ua ntej tus tswvcuab tau txais kev kuaj mob hlwb?
Rau cov tswv cuab uas pib cov kev pabcuam tshwj xeeb rau kev noj qab haus huv ntawm lub hlwb nrog Z codes, puas yog lawv yuav tsum tau kuaj mob hlwb thaum kawg, lossis Z codes puas yog tib qho kev kuaj mob uas xa mus rau kev them rov qab? Puas yog tus lej Z yog tus kab mob tseem ceeb?
(Ntxiv rau lub Peb Hlis 2026) DHCS txhais li cas los ntawm "kev ntsuas qhov muaj feem yuav muaj kev pheej hmoo siab raws li cov cuab yeej tshuaj xyuas kev raug mob uas tau pom zoo los ntawm lub chaw haujlwm"?
(Ntxiv rau lub Peb Hlis 2026) Puas yog cov cuab yeej tshuaj xyuas kev raug mob ntawm cov tub ntxhais hluas uas DHCS pom zoo yuav tsum tau los txiav txim seb tus tswv cuab puas ua tau raws li cov qauv nkag mus rau hauv SMHS lub kaw lus xa khoom?
Cov cuab yeej tshuaj xyuas kev raug mob ntawm cov hluas twg tau txais kev pom zoo los ntawm DHCS?
(Ntxiv rau lub Peb Hlis 2026) Hauv qhov chaw twg uas DHCS pom zoo siv tau cov cuab yeej tshuaj xyuas kev raug mob ntawm cov tub ntxhais hluas?
(Ntxiv rau lub Peb Hlis 2026) Cov cuab yeej tshuaj xyuas kev raug mob ntawm cov tub ntxhais hluas uas DHCS tau pom zoo uas suav nrog hauv Daim Ntawv Qhia 1 uas Medi-Cal them rov qab tau? Cov cuab yeej twg siv tau dawb?
(Ntxiv rau lub Peb Hlis 2026) Cov qauv nkag mus rau txoj cai SMHS no muaj feem cuam tshuam li cas rau lwm cov cai xws li Kev Tshuaj Xyuas thiab Kev Hloov Chaw Saib Xyuas?
Tus neeg muab kev pab cuam SMHS puas tuaj yeem xa daim ntawv thov rau SMHS uas tau muab rau tus tswv cuab uas kuj muaj tus kab mob siv tshuaj yeeb (SUD)?
Cov kws kho mob yuav ua li cas thiaj li paub tseeb tias cov tswv cuab uas muaj teeb meem siv tshuaj yeeb dej cawv (SUD) raug xa mus rau qhov chaw kho mob kom tau txais kev pab cuam SUD?
Tshuaj Kho Mob Medi-Cal Organized Delivery System (DMC-ODS) Txoj Cai Txhim Kho
Kev Sib Tham Hauv Tsev Kho Mob puas tuaj yeem tshwm sim ntawm cov neeg ua haujlwm muaj ntawv tso cai nyob hauv tib lub koom haum, lossis yuav tsum muaj kev sib tham no ntawm cov neeg ua haujlwm muaj ntawv tso cai thiab cov kws pab tswv yim sab nraud uas tau cog lus los ntawm lub nroog?
Cov Kev Pabcuam Kev Sib Tham Hauv Tsev Khomob tau them nqi li cas hauv Drug Medi-Cal Organized Delivery System (DMC-ODS)?
Puas yog kev sib tham ntawm Tus Kws Tshaj Lij Tshaj Lij Tshaj Lij Tshaj Lij Kho Mob (LPHA) thiab Tus Kws Lij Choj Kws Kho Mob (LPCC) rau kev txiav txim siab txog kev kuaj mob thiab kev kho mob yuav tsum tau them nqi siv cov lej ntsuas?
Thaum twg tus kws kho mob hauv chaw kho mob yuav them nqi rau Cov Kev Pabcuam Rov Qab Hauv Cov Tshuaj Medi-Cal Organized Delivery System (DMC-ODS)?
Yuav ua li cas tus neeg muab kev pab them nqi kho mob nyob rau hauv cov kev pab cuam bundled tus nqi rau ib hnub uas tsis muaj kev pab them nqi nyob rau hauv lub hnub ntawm kev thov?
Cov Lus Nug luv luv rau Qhov Kev Tso Cai Ua Ntej (BQuIP) puas tuaj yeem siv los ua kom tiav qhov kev ntsuam xyuas ntau yam kev saib xyuas (LOC)?
Z-codes puas tuaj yeem siv los ua qhov kev kuaj mob thawj zaug rau Cov Kev Pabcuam Medi-Cal Organized Delivery System (DMC-ODS)?
Yam kev ntsuas twg yuav tsum tau ua thaum tso cai rau Drug Medi-Cal Organized Delivery System (DMC-ODS) cov neeg siv khoom rau American Society of Addiction Medicine (ASAM) 3.1 thiab 3.5 Qib Kev Kho Mob?
Puas yog yuav tsum muaj kev tso cai ua ntej rau Kev Siv Tshuaj Kho Mob Medi-Cal Organized Delivery System (DMC-ODS) Kev Kho Mob thiab Kev Pabcuam Hauv Tsev?
Puas yog qhov kev ntsuam xyuas thoob ntiaj teb American Society of Addiction Medicine (ASAM) xav tau rau cov tswv cuab kom tau txais Kev Pabcuam Rov Qab?
Qhov yuav tsum tau nyob ntev npaum li cas rau Medi-Cal cov tswv cuab hauv cov kev pab cuam kho mob siv tshuaj nyob hauv tsev (SUD)? Puas yog cov kev cai no txawv rau cov neeg cev xeeb tub thiab tom qab yug menyuam?
Yog tias ib tug tswvcuab tab tom nqis los ntawm thaj chaw nyob mus rau tus neeg mob sab nraud Cov Kev Pabcuam Kev Noj Qab Haus Huv Medi-Cal Organized Delivery System (DMC-ODS), tus kws khomob sab nraud thiab tus kws khomob puas tuaj yeem them nqi rau Kev Pabcuam Kev Khomob thaum tus tswvcuab tseem muaj npe hauv cov kev pabcuam hauv tsev?
Rau Cov Tshuaj Kho Mob Medi-Cal Organized Delivery System (DMC-ODS), puas tseem xav tau cov phiaj xwm tso tawm thiab cov ntsiab lus tso tawm?
Kev tsis muaj tsev nyob puas tuaj yeem yog qhov laj thawj rau kev siv tshuaj tua kab mob (SUD) lossis txawm tias nce qib kev saib xyuas (LOC)?
Puas yog qhov yuav tsum tau muab naloxone ntawm qhov Kev Pabcuam Kev Kho Mob Narcotic (NTP) / Opioid Treatment Program (OTP) tuaj yeem ua tau los ntawm kev muab ib daim ntawv ntawm buprenorphine (Suboxone ® ) uas muaj buprenorphine thiab naloxone?
Tus kws kho mob yuav tsum sau nqi li cas rau qhov kev pab cuam kho mob yeeb tshuaj (NTP) thaum tus tswv cuab tau txais kev pab cuam ib ntus hauv lub nroog uas lawv tsis nyob hauv, thiab lub tsev ntawm tus tswv cuab NTP tsis muaj daim ntawv cog lus nrog lub nroog ntawd? – Cuaj Hlis 17, 2024
Cov kws kho mob uas muab kev pab cuam Drug Medi-Cal Organized Delivery System (DMC-ODS) siv Medi-Cal los sau thiab muab naloxone rau cov neeg mob li cas?
Cov tswv cuab ntawm Medi-Cal yuav siv tau cov tshuaj kho mob quav yeeb quav tshuaj (MAT) li cas?
Cov kev pabcuam them rov qab raug them li cas hauv Drug Medi-Cal Organized Delivery System (DMC-ODS)?
Yuav kom muab tau cov kev pab cuam kho mob ib nrab los ntawm Drug Medi-Cal Organized Delivery System (DMC-ODS) program, cov kev cai ntawv pov thawj twg yuav tsum tau ua tiav los ntawm DMC-ODS plan?
Cov kev cai ntawm Drug Medi-Cal Organized Delivery System (DMC-ODS) cov ntaub ntawv pov thawj txog kev tsis txaus siab yog dab tsi?
Cov kev cai ntawm Txoj Kev Npaj Tshuaj Medi-Cal Organized Delivery System (DMC-ODS) rau kev thov rov hais dua yog dab tsi?
Cov kev cai thiab lub sijhawm rau kev txiav txim plaub ntug ntawm Drug Medi-Cal Organized Delivery System (DMC-ODS) yog dab tsi?
Cov phiaj xwm thiab cov chaw muab kev pab cuam ntawm Drug Medi-Cal Organized Delivery System (DMC-ODS) yuav nrhiav tau cov lus qhia txog Daim Ntawv Ceeb Toom Txog Kev Txiav Txim Siab Txog Cov Nyiaj Pab Tsis Zoo (NOABD) cov kev tsis txaus siab thiab kev thov rov hais dua qhov twg?
Cov ntaub ntawv tsis txaus siab thiab kev thov rov hais dua twg yuav tsum muaj nyob rau hauv Txoj Kev Npaj Txhim Kho Zoo (QI) ntawm Txoj Kev Npaj Tshuaj Medi-Cal Organized Delivery System (DMC-ODS)?
Yog tias ib txoj kev npaj kho mob Drug Medi-Cal Organized Delivery System (DMC-ODS) muaj ib lub chaw haujlwm kev noj qab haus huv ntawm tus cwj pwm sib koom ua ke, nws puas siv tau tib lub Pawg Neeg Txhim Kho Zoo (QI) uas xav tau los ntawm daim ntawv cog lus Mental Health Plan los ua kom tau raws li cov kev cai ntawm Pawg Neeg DMC-ODS QI?
Cov tub ntxhais kawm xyaum ua haujlwm lossis cov neeg kawm tiav puas suav tias yog Cov Kws Kho Mob Uas Muaj Ntawv Tso Cai (LPHAs)?
}Tus kws kho mob uas tsis yog menyuam yaus puas tuaj yeem pab tus tswv cuab ntawm Drug Medi-Cal Organized Delivery System (DMC-ODS) cev xeeb tub? Cov txheej txheem thov cov kev pabcuam no yog dab tsi?
Yuav suav tus nqi rau cov kev pab tswv yim pab pawg neeg ntawm Drug Medi-Cal Organized Delivery System (DMC-ODS) li cas?
Koj puas tuaj yeem xa daim ntawv thov rau "chav pw thiab khoom noj" ntawm tus tswv cuab thaum lub sijhawm kho mob hauv tsev kho mob yog tias tus tswv cuab tsis tau txais cov kev pab kho mob hauv tsev kho mob uas them rau hnub uas tau txais kev pab rau daim ntawv thov?
Cov nyiaj tau los uas tsis yog cov nyiaj rov qab los ntawm xyoo 2011 puas tsim nyog rau kev sib tw ntawm tsoomfwv?
Cov Ntaub Ntawv Qhia Txog Tus Cwj Pwm Kev Noj Qab Haus Huv rau DMC, DMC-ODS, & SMHS
Kev soj ntsuam
Puas yog American Society of Addiction Medicine (ASAM) Cov Cai ® tuaj yeem siv los ntsuas cov tub ntxhais hluas thiab cov tub ntxhais hluas? Puas muaj kev pom zoo ASAM cov cuab yeej ntsuas rau cov hluas thiab cov tub ntxhais hluas?
Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS) puas yuav pom zoo ntxiv rau American Society of Addiction Medicine (ASAM) cov cuab yeej ntsuas?
Puas yog American Society of Addiction Medicine (ASAM) Cov Txheej Txheem Hloov Kho yuav cuam tshuam rau yav tom ntej Department of Health Care Services (DHCS) cov lus qhia?
BHIN 23-054 qhia meej tias Kev Ntsuas Tshuaj rau Kev Kho Mob (MAT) yuav tsum tau muab ua ntej 24 teev tom qab nkag mus rau cov ntawv tso cai thiab / lossis cov ntawv pov thawj siv tshuaj tsis raug cai rov qab los yog chaw kho mob. Qhov kev taw qhia no ua raws li BHIN 23-068, uas tshem tawm lub sijhawm 30/60 yav dhau los rau kev ua tiav ASAM Qib Kev Ntsuas Kev Kho Mob li cas?
Tshooj 1 Nplooj 4 ntawm Daim Ntawv Ceeb Toom Txog Tus Cwj Pwm Kev Noj Qab Haus Huv (BHIN) 23-068 tham txog cov kev taw qhia uas twb muaj lawm ntawm Department of Health Care Services (DHCS) Level of Care (LOC) uas xav kom cov neeg muab kev pab kho mob hauv tsev kom ntseeg tau tias cov tswv cuab tau txais kev ntsuam xyuas ntau theem. Puas yog cov kev cai tshiab no? Lawv puas yog qhov sib npaug ntawm cov kev ntsuas ASAM uas tau piav qhia hauv BHIN 23-068?
Tshooj 2 Puas yog qhov no txhais tau tias yuav tsum muaj ob qhov kev ntsuas sib txawv? Puas yog cov chaw muab kev pabcuam hauv tsev yuav tsum tau ua kom tiav ASAM hauv 72 teev?
Puas yog xya qhov kev ntsuas raws li tau teev tseg hauv Daim Ntawv Ceeb Toom Txog Kev Noj Qab Haus Huv (BHIN) 23-068 yuav tsum muaj rau Cov Kev Pabcuam Kev Puas Siab Puas Hlwb Tshwj Xeeb (SMHS) kev cuam tshuam lossis kev pabcuam teebmeem teebmeem? Yuav ua li cas txog Cov Kev Pabcuam Kev Puas Hlwb Tshwj Xeeb (SMHS) lossis Tshuaj Kho Mob Medi-Cal (DMC)/Drug Medi-Cal Organized Delivery System (DMC-ODS) cov kev pabcuam mobile ntsoog?
Puas yog cov kev hloov pauv rau ncua sij hawm ntsuam xyuas rau Cov Kev Pabcuam Kev Mob Siab Tshwj Xeeb cuam tshuam rau Kev Ntsuas Me Nyuam thiab Cov Hluas thiab Lub Zog (CANS) thiab Pediatric Symptom Checklist (PSC)-35? Yuav ua li cas txog Kev Ntsuam Xyuas Kev Xav Tau rau Cov Neeg Laus thiab Lub Zog (ANSA) (rau cov neeg laus)?
Yog tias Txoj Kev Npaj Kho Mob Puas Siab Puas Ntsws (MHP) muaj cov qauv ntsuas tam sim no nyob rau hauv lawv cov ntaub ntawv kho mob hluav taws xob uas ntes tag nrho xya (7) Cov Kev Pabcuam Kev Puas Siab Puas Hlwb Tshwj Xeeb (SMHS), MHP puas yuav tsum tau rov ua lawv cov kev ntsuam xyuas, yog li nws yog categorized los ntawm tus tshiab domains?
Puas yog xya (7) lub luag haujlwm rau Kev Ntsuam Xyuas Tshwj Xeeb Kev Pabcuam Kev Puas Siab Puas Ntsws yuav tsum muaj rau kev ntsuam xyuas kev puas siab puas ntsws?
Cov kws kho mob puas yuav sau cov laj thawj rau kev siv sijhawm ntau dua li niaj zaus los ua kom tiav qhov kev ntsuas?
Kev Npaj Kho Mob
- Cov Ntaub Ntawv Txog Kev Noj Qab Haus Huv Electronic (EHR) puas tuaj yeem siv rau cov phiaj xwm saib xyuas?
- Do providers of substance use disorder (SUD) services funded through the Substance Abuse and Mental Health Services’ (SAMHSA) Substance Use Prevention, Treatment, and Recovery Services Block Grant (SUBG) need to complete standalone treatment plans?
Cov npe teeb meem
- Cov npe teeb meem puas tuaj yeem siv los ua cov phiaj xwm saib xyuas?
- Dab tsi yog qhov txawv ntawm daim ntawv teev cov teeb meem thiab daim ntawv them nqi lossis thawj qhov kev kuaj mob?
- Tus kws kho mob puas tuaj yeem hloov kho cov npe teeb meem kom suav nrog kev kuaj mob uas tsis yog lawv qhov kev coj ua (piv txwv li, tus tswvcuab tshaj tawm txog kev kuaj mob qog noj ntshav rau Tus Kws Lij Choj thiab Tsev Neeg Therapy)?
- Cov kws kho mob puas tuaj yeem ntxiv cov teeb meem rau cov npe teeb meem uas tsis kuaj tau?
- Does identifying a staff’s credential (e.g., LCSW) meet the requirement for “title” of provider in the problem list?
- Because it is not feasible for all currently opened members to be transferred to having a problem list, what is DHCS’ expectation for when members who have been opened prior to 7/1/22 get a problem list?
Cov Lus Ceeb Toom
Tus kws kho mob yuav ua li cas sau ib daim ntawv qhia kev kawm rau ib tug tswv cuab uas tau txais ntau tshaj ib qho kev pab cuam thaum lub sij hawm ntsib ib qho kev pabcuam?
Historically, stakeholders have raised concerns regarding burdensome requirements for progress note documentation. What sources did the Department of Health Care Services (DHCS) review to ensure DHCS’ progress note documentation requirements outlined in Behavioral Health Information Notice (BHIN) 23-068 align with current industry standards?
Yuav ua li cas sau ntawv ua tiav rau pab pawg yog tias ob tus neeg muab kev pabcuam ua haujlwm pab pawg?
Cov kos npe digital puas ua tau raws li qhov yuav tsum tau kos npe rau kev ua tiav cov ntawv sau ua tiav?
Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS) puas yuav hloov kho lub sijhawm sau ntawv ua tiav tau teev tseg hauv Daim Ntawv Ceeb Toom Txog Kev Noj Qab Haus Huv (BHIN) 23-068? Lub sijhawm no siv li cas thaum sau ntawv ua tiav los ntawm cov chaw muab kev pabcuam hauv kev saib xyuas?
Yuav ua li cas daim ntawv ceeb toom kev kawm nyob rau hauv Behavioral Health Information Notice (BHIN) 23-068 siv rau cov kev pab cuam xws li ib tus nqi diem rau kev kho mob hauv tsev?
Cov kws kho mob yuav tsum sau cov kev pabcuam pab pawg li cas yog tias nws muab los ua ib feem ntawm cov kev pabcuam pob khoom? Piv txwv li, cov tswv cuab tau txais kev kho mob hauv tsev tuaj yeem koom nrog kev pabcuam pab pawg nrog rau lwm yam kev pabcuam lossis kev ua ub no thaum lub sijhawm kawm ib hnub.
Cov neeg koom nrog pab pawg puas tuaj yeem hloov daim ntawv sau tseg rau ib pawg neeg hauv cov ntaub ntawv cov tswv cuab?
Puas yog daim ntawv ceeb toom ua tiav tau teev tseg hauv Daim Ntawv Ceeb Toom Txog Kev Noj Qab Haus Huv Tus Cwj Pwm (BHIN) 23-068 Dab tsi yog qhov tsawg kawg nkaus los ntawm DHCS?
Cov ntawv sau ua tiav puas yuav tsum suav nrog Phau Ntawv Qhia Txog Kev Tshawb Fawb thiab Kev Tshawb Fawb Txog Kev Puas Siab Puas Ntsws (DSM-5) ntxiv rau International Classification of Diseases, Tenth Revision (ICD-10) code?
Puas yog cov tswv cuab kos npe kos npe rau cov ntawv sau ua haujlwm pab pawg?
Kev Pabcuam, Kev Pabcuam, & Cov Kev Xav Tau
- Qee tus kws kho mob tus cwj pwm coj tus cwj pwm Medi-Cal tau cog lus nrog Managed Care Plans (MCPs) uas muab Kev Tswj Xyuas Kev Kho Kom Zoo (ECM). Cov kws kho mob puas yuav tsum tau ua raws li ob qhov sib txawv ntawm cov ntaub ntawv xav tau rau Medi-Cal kev pabcuam kev noj qab haus huv thiab ECM?
- Koj puas tuaj yeem qhia meej tias qhov yuav tsum tau teev tseg hauv Enclosure 1a ntawm BHIN 23-068 txhais li cas? Piv txwv li, cov chaw kho mob hauv Cov Neeg Laus puas tau ntawv tso cai los ntawm CDSS thiab tau lees paub los ntawm DHCS yuav tsum tau tsim cov phiaj xwm kho mob ntxiv? Yuav ua li cas txog SUD cov chaw muab kev pabcuam hauv tsev uas tuav Qib Kev Pabcuam?
- Puas yog cov tswvcuab tau txais Kev Pabcuam Kev Noj Qab Haus Huv Medi-Cal (DMC) thiab Tshuaj Khomob Medi-Cal Organized Delivery System (DMC-ODS) yuav tsum muaj kev kuaj mob thiab kev soj ntsuam ua tiav li ntawm 30 hnub ntawm kev nkag mus kho?
- Koj puas tuaj yeem piav qhia qhov yuav tsum tau ua rau Kev Pabcuam Kev Puas Siab Puas Hlwb Tshwj Xeeb (SMHS) Targeted Case Management (TCM)? Puas yog txoj cai txawv ntawm txoj cai uas nyob hauv BHIN 22-019 (tam sim no hloov pauv)?
- Dab tsi yog qhov txawv ntawm Targeted Case Management (TCM) thiab Intensive Care Coordination (ICC)? Puas yog xav tau kev npaj saib xyuas rau ICC?
- Puas yog cov ntsiab lus txhua lub limtiam tseem xav tau rau kev siv tshuaj yeeb dawb (SUD) qib kev saib xyuas nyob hauv tsev?
- Puas yog Drug Medi-Cal Organized Delivery System (DMC-ODS) kev saib xyuas zoo ib yam li Targeted Case Management (TCM)?
- Cov Kev Pabcuam Targeted Case Management (TCM) puas tuaj yeem muab tau ua ntej kev soj ntsuam thiab ua tiav ntawm TCM Care Plan?
Lwm yam
"Cov hnub ua haujlwm" txhais li cas hauv Tshooj (d)(5) ntawm nplooj ntawv 10 ntawm BHIN 23-068? – Lub Kaum Ob Hlis 3, 2024
Kuv puas tseem yuav tsum ua raws li cov cai ntawm cov ntaub ntawv rau cov lej tshwj xeeb ntawm Healthcare Common Procedure Coding System (HCPCS)/Current Procedural Terminology ® (CPT), xws li Evaluation and Management (E/M) CPT?
Puas yog qhov laj thawj rau kev pabcuam txuas ntxiv mus tseem yog qhov yuav tsum tau ua rau cov kev pabcuam kev siv tshuaj yeeb dej cawv (SUD) tseem siv tau?
Puas yuav tsum tau kuaj lub cev rau cov kev pab cuam kho mob rau cov neeg mob sab nraud thiab cov neeg nyob hauv tsev uas muaj teeb meem siv tshuaj yeeb (SUD)?
Puas yuav tsum muaj cov ntawv kos npe rau cov tswv cuab rau cov kev pabcuam pab pawg? Yuav ua li cas txog cov kos npe ntawm cov tswv cuab?
Vim li cas Cov Kev Pab Cuam Kho Mob Tshuaj Yeeb (NTPs) thiaj zam tsis pub muaj cov lus qhia hauv Daim Ntawv Ceeb Toom Txog Kev Noj Qab Haus Huv Tus Cwj Pwm 23-068?
Puas tau hloov cov kev cai rau kev pom zoo rau kev siv tshuaj? Ntu no tau raug tshem tawm ntawm Specialty Mental Health Services (SMHS) Triennial Protocol thiab Daim Ntawv Cog Lus Kev Noj Qab Haus Huv Lub Siab (MHP) Daim Ntawv Cog Lus thiab Daim Ntawv Qhia Txog Kev Noj Qab Haus Huv Tus cwj pwm (BHIN) 23-068 tsis kov cov kev cai pom zoo rau kev siv tshuaj.
Yog tias cov kws kho mob ntawm Mental Health Plan (MHP) tam sim no tuaj yeem muab kev kho mob ua ke thiab tsom mus rau tus tswv cuab cov kev xav tau kev siv tshuaj yeeb (SUD) raws li kev kho mob tsim nyog, qhov ntawd puas txhais tau tias tus tswv cuab cov ntaub ntawv kho mob nrog MHP tam sim no yuav raug tswj hwm los ntawm 42 CFR Ntu 2?
Puas yog cov kev cai ntawm Medicare raug coj los xav txog vim tias cov nroog yuav tsum them nqi rau Medicare ua ntej? Cov tswv cuab uas muaj Medicare thiab Medi-Cal puas xav tau cov phiaj xwm kho mob?
Yuav kom txo lub sijhawm sau ntawv, puas siv tau cov thawv cim tshwj tsis yog tias xav tau "zaj dab neeg"?
(Ntxiv rau lub Kaum Ob Hlis 2022) Puas tseem muaj qhov yuav tsum tau ua ntawm Drug Medi-Cal Organized Delivery System (DMC-ODS) los sau cov ntaub ntawv kuaj mob ua cov lus piav qhia raws li Diagnostic and Statistical Manual of Mental Disorders (DSM-)5 cov qauv?
Cov kws kho mob yuav sau cov ntaub ntawv li cas txog kev koom tes ntawm tus tswv cuab hauv cov txheej txheem kho mob?
Tsis Muaj Qhov Rooj Tsis Zoo & Kev Kho Kom Zoo
- (Ntxiv Lub Kaum Ob Hlis 2022) Yog tias nyob rau hauv Txoj Cai Tsis Muaj Qhov Rooj Tsis Zoo, ib tus tswvcuab tuaj yeem khaws tau tus kws kho mob NSMHS Medi-Cal uas twb muaj lawm thaum tseem tau txais SMHS los ntawm MHP, puas yog yuav tsum tau ua raws li tus kws kho mob kuaj xyuas thiab cog lus Kev Saib Xyuas Txuas Ntxiv ( CoC) cov cai rau BHIN 18-059?
- (Ntxiv Lub Kaum Ob Hlis 2022) Yuav Ua Li Cas Qhov Tsis Muaj Qhov Rooj Tsis Zoo thiab Cov Txheej Txheem rau Cov Tswvcuab Kev Nkag Mus Rau SMHS cov cai cuam tshuam rau AB 1299 qhov xav tau hloov pauv (PT) xav tau li cas?
- (Ntxiv rau lub Kaum Ob Hlis 2022) Puas yog ib tus neeg muab kev pabcuam SMHS, thaum lawv tab tom muab SMHS rau ib tus tswvcuab, hais txog kev txhawj xeeb txog kev siv tshuaj yeeb hauv SMHS muab rau tus tswvcuab?
- (Ntxiv Lub Kaum Ob Hlis 2022) Puas yog ib tus kws kho mob DMC/DMC-ODS, thaum lawv tab tom muab kev pabcuam SUD rau ib tus tswvcuab, hais txog kev txhawj xeeb txog kev puas siab puas ntsws nyob rau hauv cov kev pabcuam muab rau tus tswvcuab?
Standardized Screening thiab Transition Tools
(Ntxiv Lub Ob Hlis 2023) Vim li cas Kev Tshuaj Ntsuam Xyuas thiab Hloov Kho Cov Cuab Yeej Kho Mob rau Medi-Cal Cov Kev Pab Cuam Kev Puas Siab Puas Ntsws tau raug coj los siv?
(Ntxiv Lub Ob Hlis 2023) Lub hom phiaj ntawm Cov Kev Ntsuas Cov Neeg Laus thiab Cov Hluas rau Medi-Cal Mental Health Services yog dab tsi?
(Ntxiv Lub Ob Hlis 2023) Puas yog Cov Kev Ntsuam Xyuas Cov Cuab Yeej npaj los ua haujlwm raws li kev soj ntsuam los txiav txim siab txog kev kho mob uas tsim nyog?
(Ntxiv Lub Ob Hlis 2023) Puas Yog Cov Cuab Yeej Siv Tshuaj ntsuam xyuas qhov kev xav tau ntawm kev siv tshuaj yeeb?
(Ntxiv Lub Ob Hlis 2023) Lub hom phiaj ntawm Kev Hloov Kho Kev Kho Mob rau Medi-Cal Kev Pabcuam Kev Puas Siab puas ntsws yog dab tsi?
(Ntxiv Lub Ob Hlis 2023) Puas yog Kev Hloov Kho Kev Kho Mob yog npaj los ua haujlwm raws li kev ntsuas los txiav txim siab txog kev kho mob uas tsim nyog?
(Ntxiv Lub Ob Hlis 2023) Puas yog Cov Cuab Yeej Siv Tshuaj Ntsuam Xyuas thiab Hloov Kho Cov Cuab Yeej Kho Mob npaj siv ua ke?
(Ntxiv Tsib Hlis 2023) DHCS puas yuav hloov kho cov cuab yeej? Yog muaj, thaum twg?
(Ntxiv Lub Ob Hlis 2023) Leej twg yuav tsum siv Cov Cuab Yeej Ntsuas?
(Ntxiv Lub Ob Hlis 2023) Puas yog MCPs thiab MHPs yuav tsum siv Cov Cuab Yeej Siv Tshuaj Ntsuam Xyuas nrog txhua tus neeg uas hu rau lawv rau lub hom phiaj twg?
(Hloov Kho Lub Xya Hli 2023) Puas yog Cov Cuab Yeej Kev Ntsuam Xyuas yuav tsum muaj thaum tib neeg raug xa los ntawm tus kws kho mob mus rau MCP rau NSMHS lossis MHP rau SMHS?
(Ntxiv Lub Xya Hli 2023) Puas yog MCPs/MHPs yuav tsum tau siv Kev Tshuaj Ntsuam Xyuas thiab Hloov Kho Cov Cuab Yeej Kho Mob nrog cov neeg tsis muaj ntawv pov hwm thiab/lossis cov ntawv pov hwm ntiag tug?
(Ntxiv Lub Ob Hlis 2023) Leej twg yuav tsum tau siv Cov Kev Hloov Kho Kev Kho Mob?
(Ntxiv Lub Xya Hli 2023) Leej twg tuaj yeem txiav txim siab seb tus neeg twg uas tam sim no tau txais kev pabcuam kev puas siab puas ntsws los ntawm MCP lossis MHP yuav tsum tau txais kev pabcuam ntxiv uas tau them los ntawm lwm qhov Medi-Cal kev pabcuam kev noj qab haus huv (piv txwv li, MCP lossis MHP) lossis xav tau kom lawv txoj kev saib xyuas hloov mus rau lwm qhov Medi-Cal kev kho mob hlwb (xws li, MCP lossis MHP)?
(Ntxiv rau lub Tsib Hlis 2023) Cov kws kho mob yuav paub li cas yog tias lawv yuav tsum siv Cov Kev Hloov Kho Kev Kho Mob?
(Ntxiv Lub Ob Hlis 2023) Puas yog Kev Hloov Kho Kev Kho Mob yuav tsum tau siv thaum ib tus neeg raug xa mus rau hauv tib txoj kev xa khoom?
(Ntxiv Lub Tsib Hlis 2023) Puas yog Kev Hloov Kho Kev Kho Mob xav tau yog tias ib tus neeg tshuaj ntsuam rau hauv MCP lossis MHP tab sis lawv qhov kev soj ntsuam kuaj pom tias lawv nyob hauv lwm qhov system?
(Ntxiv Lub Ob Hlis 2023) Cov lus nug / teb puas tuaj yeem ntxiv rau Kev Ntsuam Xyuas thiab Hloov Kho Cov Cuab Yeej Kho Mob thiab/lossis cov cuab yeej puas tuaj yeem ua ke nrog cov cuab yeej uas twb muaj lawm?
(Ntxiv Lub Tsib Hlis 2023) Puas tuaj yeem ntxiv cov pej xeem thaj chaw ntxiv rau Cov Cuab Yeej Ntsuas?
(Ntxiv rau lub Tsib Hlis 2023) Puas muaj cov ntaub ntawv ntxiv uas muab tau ua cov ntawv sau lossis cov ntawv txuas rau Cov Cuab Yeej Tshuaj Xyuas ?
(Ntxiv rau lub Ob Hlis 2023) Cov neeg uas tswj cov Cuab Yeej Tshuaj Xyuas puas tuaj yeem hloov pauv ntawm cov lus tshwj xeeb yog tias lawv raug hais kom piav qhia ib lo lus nug?
(Ntxiv rau lub Ob Hlis 2023) Puas yog qhov kev hloov pauv ntawm cov lus tshwj xeeb hauv Cov Cuab Yeej Tshuaj Xyuas raug tso cai ua ib feem ntawm kev txhais lus?
(Ntxiv rau lub Tsib Hlis 2023) Thaum ib tug neeg teb tias yog rau cov lus nug 6, 7, lossis 9 ntawm Cov Cuab Yeej Tshuaj Xyuas Hluas, vim li cas cov lus qhia thiaj li yuav tsum kom tus neeg tshuaj xyuas tsum tsis txhob tshuaj xyuas? Tus neeg tshuaj xyuas puas tseem nug cov lus nug tshuaj xyuas uas tseem tshuav?
(Ntxiv rau lub Ob Hlis 2023) Puas yog MCPs thiab MHPs yuav tsum tsim cov Cuab Yeej Tshuaj Xyuas thiab Kev Hloov Kho Kev Saib Xyuas rau hauv lawv cov ntaub ntawv kho mob hauv hluav taws xob?
(Ntxiv rau lub Xya Hli 2023) MHPs yuav tsum thov li cas rau cov haujlwm ua tiav raws li ib feem ntawm Cov Cuab Yeej Tshuaj Xyuas thiab Kev Hloov Kho Kev Saib Xyuas?
(Ntxiv rau lub Ob Hlis 2023) Cov qhab nia ntawm Cov Cuab Yeej Tshuaj Xyuas txiav txim siab li cas?
(Ntxiv rau lub Tsib Hlis 2023) Yog tias ib tus neeg muaj qhov qhab nia tshuaj ntsuam tag nrho ntawm "0" puas txhais tau tias lawv tsis xav tau kev pab kho mob hlwb hauv ob qho kev xa mus?
(Ntxiv rau lub Ob Hlis 2023) Yuav ua li cas yog tias tus neeg uas tswj hwm Cov Cuab Yeej Tshuaj Ntsuam tsis pom zoo nrog qhov qhab nia tshuaj ntsuam? Puas yog MCPs thiab MHPs yuav tsum ua raws li qhov kev xa mus rau lub cev xa mus uas qhia los ntawm qhov qhab nia tshuaj ntsuam?
(Ntxiv rau lub Ob Hlis 2023) Puas muaj txoj kev ntsuas rau Cov Cuab Yeej Hloov Chaw Saib Xyuas?
(Ntxiv rau lub Xya Hli 2023) Puas yog MCPs/MHPs yuav tsum tshaj tawm Daim Ntawv Ceeb Toom Txog Kev Ua (NOA)/Daim Ntawv Ceeb Toom Txog Kev Txiav Txim Siab Txog Cov Nyiaj Pab Tsis Zoo (NOABD) yog tias ib tus neeg raug xa mus rau lwm lub cev xa mus rau Medi-Cal kev xa mus rau kev kho mob hlwb raws li lawv qhov qhab nia tshuaj ntsuam?
(Ntxiv rau lub Xya Hli 2023) MCPs/MHPs yuav tsum ua li cas yog tias ib tus neeg tsis kam txais qhov kev xa mus raws li lawv qhov qhab nia tshuaj ntsuam?
(Ntxiv rau lub Ob Hlis 2023) Cov MCPs thiab MHPs puas raug tso cai rov kuaj xyuas cov tib neeg yog tias lawv xav tias lawv tsis tau qhab nia tsim nyog?
(Ntxiv rau lub Ob Hlis 2023) Yuav tsum tau teem sijhawm ntev npaum li cas tom qab tau txais kev xa mus los ntawm lwm lub tshuab xa khoom, MCPs thiab MHPs yuav tsum teem sijhawm rau kev ntsuam xyuas kev kho mob?
(Ntxiv rau lub Ob Hlis 2023) Yuav ua li cas yog tias ib tus neeg raug xa mus rau MCP lossis MHP raws li lawv qhov qhab nia ntsuam xyuas, tab sis lawv qhov kev ntsuam xyuas kev kho mob tom qab ntawd qhia tias lawv koom nrog lwm lub tshuab xa khoom?
(Ntxiv rau lub Xya Hli 2023) MCPs/MHPs yuav tsum ua li cas yog tias lawv muaj teeb meem tiv tauj nrog ib tus neeg uas tau raug xa mus rau MCP lossis MHP cov kev pabcuam?
(Ntxiv rau lub Ob Hlis 2023) DHCS puas yuav muab cov qauv txhais lus ntawm Cov Cuab Yeej Tshuaj Xyuas?
(Ntxiv rau lub Ob Hlis 2023) Puas muaj cov kev cai tshaj tawm rau Kev Tshuaj Xyuas thiab Kev Hloov Chaw ntawm Cov Cuab Yeej Saib Xyuas?
(Ntxiv rau lub Ob Hlis 2023) Cov Cuab Yeej Tshuaj Xyuas puas sib haum nrog txoj cai Tsis Muaj Qhov Rooj Tsis Yog?
Kev Them Nyiaj Them Nqi Kev Noj Qab Haus Huv Tus Cwj Pwm
- Nkag mus rau BH Payment Reform FAQs ntawm BH CalAIM webpage.
Behavioral Health Administration Integration
(Ntxiv rau lub Tsib Hlis 2023) DHCS puas tuaj yeem muab cov ncauj lus kom ntxaws ntxiv ntawm daim ntawv thov kom ua tiav DHCS-Lub Nroog daim ntawv cog lus nrog Xyoo Daim Ntawv Teev Npe uas tsis yog Xyoo Nyiaj Txiag?
(Ntxiv Lub Tsib Hlis 2023) DHCS yuav txhawb nqa lub nroog li cas kom ua tau raws li Kev Tswj Xyuas Kev Noj Qab Haus Huv Kev Noj Qab Haus Huv los ntawm Lub Ib Hlis 1, 2027?
(Ntxiv Tsib Hlis 2023) Cov txiaj ntsig zoo li cas rau cov nroog uas tuaj yeem pab dawb rau kev sib cog lus thaum ntxov?
(Ntxiv Lub Tsib Hlis 2023) Kev Tswj Xyuas Kev Noj Qab Haus Huv Kev Noj Qab Haus Huv yuav zoo li cas rau cov nroog uas tsis tuaj yeem pab dawb rau kev sib cog lus ntxov?
(Ntxiv Lub Tsib Hlis 2023) Kev Tswj Xyuas Kev Noj Qab Haus Huv Kev Noj Qab Haus Huv yuav zoo li cas rau cov nroog Medi-Cal (DMC)?
(Ntxiv rau lub Tsib Hlis 2023) Kev Tswj Tus Cwj Pwm Kev Noj Qab Haus Huv yuav ua li cas rau cov nroog uas nyob hauv Drug Medi-Cal-Organized Delivery System (DMC-ODS) Regional Model?
(Ntxiv rau lub Tsib Hlis 2023) Kev Tswj Tus Cwj Pwm Kev Noj Qab Haus Huv puas yuav tsum muaj kev sib koom ua ke Memoranda of Understanding (MOU) ntawm MCPs thiab Behavioral Health Plans?
(Ntxiv Lub Tsib Hlis 2023) Txoj Cai Tswj Kev Noj Qab Haus Huv Kev Noj Qab Haus Huv ua haujlwm li cas nrog rau lwm qhov kev hloov kho CalAIM txoj cai xws li Tsis Muaj Qhov Rooj, Cov Ntaub Ntawv Kho Dua, thiab Cov Txheej Txheem Kev Ntsuas thiab Hloov Cov Cuab Yeej?
(Ntxiv Lub Tsib Hlis 2023) Kev them nyiaj yuav ua haujlwm li cas nrog Kev Tswj Kev Noj Qab Haus Huv Kev Noj Qab Haus Huv?
(Ntxiv Lub Tsib Hlis 2023) Kev Tswj Kev Noj Qab Haus Huv Kev Noj Qab Haus Huv yuav ua li cas txhim kho cov tswv cuab kev paub?
(Ntxiv Lub Tsib Hlis 2023) Puas yog Kev Coj Tus Cwj Pwm Kev Noj Qab Haus Huv Kev Noj Qab Haus Huv txhais tau tias cov nroog yuav tsum tau hloov kho kom cov kab mob kev puas siab puas ntsws thiab kev siv tshuaj yeeb dej caw tag nrho nyob rau hauv ib lub chaw saib xyuas kev noj qab haus huv hauv lub nroog?
(Ntxiv Lub Tsib Hlis 2023) Raws li cov nroog siv Kev Coj Tus Cwj Pwm Kev Noj Qab Haus Huv Kev Noj Qab Haus Huv, DHCS tuaj yeem muab cov peev txheej dab tsi los txhawb cov nroog hauv kev tswj hwm kev ua raws li 42 CFR Tshooj 2 cov cai nyob ib puag ncig cov ntaub ntawv siv tshuaj yeeb dawb?
(Ntxiv rau lub Tsib Hlis 2023) Kev Tso Cai Qhia Txog Cov Ntaub Ntawv Qhia Txog Medi-Cal Tsis pub twg paub (ASCMI) Pilot tam sim no tab tom ua raws li kev coj noj coj ua ntawm Kev Tswj Xyuas Kev Noj Qab Haus Huv li cas?
(Ntxiv rau lub Tsib Hlis 2023) Txoj Kev Qhia Txog Kev Coj Tus Cwj Pwm Kev Noj Qab Haus Huv Cov Ntaub Ntawv Ua Haujlwm Zoo li cas nrog Kev Tswj Tus Cwj Pwm Kev Noj Qab Haus Huv?
(Ntxiv Lub Tsib Hlis 2023) Cov nroog puas yuav tau txais cov qauv lossis kev taw qhia los pab tsim cov phiaj xwm kev coj noj coj ua zoo sib xws thiab cuam tshuam?
(Added May 2023) How will DHCS ensure that the integrated EQR process includes adequate focus on both mental health and substance use disorder priorities aren’t lost in the aim to have an integrated EQR?
(Added May 2023) What will counties’ compliance reviews look like under Behavioral Health Administrative Integration?
(Ntxiv Lub Tsib Hlis 2023) DHCS yuav ua li cas kom ntseeg tau tias cov txheej txheem Network Tsim nyog tshiab tseem ua kom muaj kev txaus siab rau ob qho tib si kev siv yeeb tshuaj thiab kev noj qab haus huv ntawm lub hlwb?
(Ntxiv Tsib Hlis 2023) Cov Kev Pabcuam Kev Noj Qab Haus Huv Kev Noj Qab Haus Huv yuav cuam tshuam li cas?
(Ntxiv Kaum Ib Hlis 2023) Puas yog kev sib koom ua ke 24/7 cov kab nkag yuav tsum tau ua los ntawm lub nroog, lossis cov nroog puas tuaj yeem siv cov neeg muag khoom / cov neeg ua haujlwm subcontract?
(Ntxiv Kaum Ib Hlis 2023) Txhua theem ntawm Kev Tswj Xyuas Kev Noj Qab Haus Huv Kev Noj Qab Haus Huv muaj dab tsi?
(Added November 2023) Will there be an annual spending limit specified in the integrated contracts, similar to the current approach for counties’ DMC and DMC-ODS contracts? If not, will the removal of those annual limits affect State General Fund (SGF) contributions for, or any limits that may exist on, specific DMC or DMC-ODS services?
(Ntxiv rau lub Kaum Ib Hlis 2023) Raws li cov ntawv cog lus sib koom ua ke, cov nroog yuav thov li cas rau cov nuj nqis ntsig txog cov kev pabcuam Medi-Cal, kev pov hwm zoo & tshuaj xyuas kev siv (QA/UR), kev cog lus ntsig txog kev tswj hwm, thiab Kev Noj Qab Haus Huv Kev Noj Qab Haus Huv Medi-Cal Kev Tswj Xyuas Kev Ua Haujlwm ( MH MAA)?
(Ntxiv Lub Plaub Hlis 2024) Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS) yuav ua li cas txhawm rau txheeb xyuas qhov sib txawv ntawm cov cai thiab cov cai ntawm cov kev pabcuam tshwj xeeb rau kev puas siab puas ntsws (SMHS) thiab Tshuaj Medi-Cal (DMC)/Drug Medi-Cal Organized Delivery System (DMC- ODS) cov kev pab cuam hauv daim ntawv cog lus ua ke?
(Ntxiv Lub Plaub Hlis 2024) Rau txoj kab sib txuas 24/7, Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS) puas xav kom cov nroog siv tus lej xov tooj hauv zos, lossis lawv puas tuaj yeem siv tus lej xov tooj hu dawb?
(Ntxiv Lub Plaub Hlis 2024) Yuav Ua Li Cas Kev Ntsuam Xyuas Sab Nraud Zoo (EQRs) ua haujlwm raws li kev cog lus ua ke?
(Ntxiv rau lub Plaub Hlis 2024) Cov Kev Ntsuam Xyuas Tus Cwj Pwm Kev Noj Qab Haus Huv (BH) yuav ua haujlwm li cas raws li kev cog lus sib koom ua ke ntawm cov qauv thiab zaus?
(Ntxiv rau lub Plaub Hlis 2024) Yuav Kev Tshawb Fawb Txog Kev Noj Qab Haus Huv (BH) puas suav nrog kev tshuaj xyuas txog Kev Tiv Thaiv Kev Siv Tshuaj, Kev Kho Mob thiab Kev Pabcuam Rov Qab Los Block Grant (SUBG) ntxiv rau Cov Kev Pabcuam Kev Mob Siab Tshwj Xeeb (SMHS) thiab Tshuaj Medi-Cal (DMC) /Drug Medi-Cal Organized Delivery System (DMC-ODS) cov kev pab cuam?
(Ntxiv Lub Plaub Hlis 2024) Yuav ua li cas kev koom ua ke cov ntawv pov thawj tsim nyog ua haujlwm? Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS) puas xav kom cov nroog xa tawm ob qho tib si txhua xyoo Network Adequacy Certification Tool (NACT) thiab cov ntaub ntawv nkag mus raws sijhawm ntxiv rau txhua hli 274 Electronic Data Interchange (274 tus qauv) cov ntaub ntawv network?
(Ntxiv rau lub Plaub Hlis 2024) Yog tias Lub Nroog Lub Tsev Muag Tshuaj Medi-Cal Organized Delivery System (DMC-ODS) tsis tau ua tiav txhua hli 274 Electronic Data Interchange (274 tus qauv) muab cov ntaub ntawv xa tawm hauv lub network, puas yuav txwv tsis pub lawv los ntawm kev koom tes hauv Phase 2 kev sib koom ua ke nrog kev cog lus?
(Ntxiv rau lub Plaub Hlis 2024) Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS) puas yuav kho lossis hloov cov txheej txheem uas siv los ntsuas qhov tsim nyog hauv lub network raws li kev cog lus sib koom ua ke?
Coding Thaum Kev Ntsuam Xyuas
- (Added December 2022) If a member receiving services from an MHP has a co-occurring substance use disorder (SUD), and the mental health provider’s session only focuses on the SUD need, is this acceptable? What about a DMC or DMC-ODS provider serving a member with a mental health disorder?
- ICD-10 cov lej twg yuav tsum tus kws kho mob siv los thov rau cov kev pabcuam muab rau tus tswvcuab uas tseem tsis tau txais kev kuaj mob?
Ua raws
- (Ntxiv Lub Kaum Ob Hlis 2022) Yuav ua li cas cov nroog yuav tsum saib xyuas kev dag, pov tseg, thiab kev tsim txom?
- (Added December 2022) What are the definitions of fraud, waste, and abuse? Is “intent” a requirement for fraud to be present?
Kev thov
- (Ntxiv rau lub Kaum Ob Hlis 2022) Cov kev pabcuam hnub tswj hwm puas tuaj yeem thov rau qhov xwm txheej lossis cov chaw uas tsis yog thaum cuam tshuam nrog cov tswvcuab txav los ntawm lub tsev kho mob puas siab puas ntsws mus rau qhov chaw kho mob tsis zoo nyob hauv tsev?
- (Ntxiv Lub Kaum Ob Hlis 2022) Yog tias ib tus tswvcuab thov kev pabcuam nrog lwm lub nroog Medi-Cal tab sis tsis ua raws li kev hloov lawv Medi-Cal hauv 30 hnub, lawv cov kev pabcuam puas yuav raug them rau lub hli dhau los?
- (Added December 2022) Are designated mental health workers who are not license-eligible or waivered able to bill the “assessment” code at the same rate as an LPHA?
- (Ntxiv Lub Kaum Ob Hlis 2022) Txhua qhov kev thov rau SMHS xa los ntawm MHP los ntawm Short-Doyle system yuav tsum suav nrog ICD-10-CM kuaj mob / laj thawj rau kev sib ntsib. Puas tuaj yeem xa daim ntawv thov uas tsuas yog siv cov khoom siv tshuaj tiv thaiv kab mob?
Memorandum of Understanding (MOU)
- Dab tsi yog cov txheej txheem xa tawm rau peb lub hlis twg rau DHCS rau MCPs, MHPs, thiab DMC-ODS?
- Are MHPs and DMC-ODS county network/contracted providers required to be signatories to their delivery system’s respective MOU?
- Puas yog MCPs, MHPs, thiab DMC-ODS counties yuav tsum xa ib daim redline version ntawm txhua qhov hloov tshiab rau tus qauv, suav nrog kev siv cov kev xaiv xaiv?
- Puas yog MHP thiab DMC-ODS MOU Templates suav nrog hauv BHINs 23-056 thiab 23-057 zoo ib yam rau MHP thiab DMC-ODS MOU Templates suav nrog hauv APL 23-029 thiab MHP thiab DMC-ODS MOU Templates ntawm MCP MOU lub vev xaib?