Tsev Xov Xwm Txog Cov Neeg Muaj Feem Cuam Tshuam ntawm DHCS - Tsib Hlis 19, 2023​​ 

DHCS Stakeholder News – May 19, 2023​​ 

Kev hloov kho tshiab​​   

Medi-Cal Rx​​  

On May 19, Reinstatement Phase III, Lift 3 will be implemented, lifting the Transition Policy for 22 Standard Therapeutic Classes (STCs) for members age 22 and older. This is the third in a series of lifts to retire, or phase out, the grandfathering of historical prior authorizations (PA) and claims by reinstating NCPDP Reject Code 75 – Prior Authorization Required.​​  

Cov kev cai PA rau 46 qhov STCs uas tseem tshuav yuav raug muab rov qab rau hauv Phase 3, Lift 4, tam sim no npaj rau kev siv rau lub Rau Hli 23, 2023.​​  

California Unwinding Monthly Report rau lub Plaub Hlis 2023​​  

On May 22, DHCS will publish California’s submission of the federal “Unwinding Monthly Report” for the eligibility month of April 2023 to the Centers for Medicare & Medicaid Services (CMS) as part of the continuous coverage unwinding federal requirements. The report includes California’s updated estimate of total pending applications received between March 1, 2020, and March 31, 2023, that are still in a pending status as of April 30; total April 2023 annual renewals and renewal outcomes; and total Medi-Cal fair hearings pending more than 90 days as of April 30. The report also includes a description of California’s renewal timeline and policy during the unwinding period. This report will be posted to the DHCS Medi-Cal Enrollment webpage under “DHCS Continuous Coverage Unwinding Data.” Each monthly report will include the same measures, but specific for that month. DHCS will provide reports to CMS on or about the 20th of each month through at least June 2024.​​  

Koom nrog peb pab neeg​​    

DHCS muaj ob qhov qhib tam sim ntawd rau ob txoj haujlwm tshiab:​​  

DHCS is dedicated to preserving and improving the overall health and well-being of all Californians. DHCS’ mission is to provide the most vulnerable residents with equitable access to affordable, integrated, high-quality health care, and is currently transforming the Medi-Cal program to make sure it provides the care Californians need to live healthier, happier lives. For more information, please visit the CalCareers website.  ​​  

Cov Rooj Sib Tham Cov Neeg Koom Tes thiab Webinar yuav los tom ntej​​   

Dementia Care Aware – Cognitive Health Assessment (CHA) Virtual Training​​  

Pib txij lub Tsib Hlis 19, Dementia Care Aware tab tom muab kev cob qhia Zoom txhua hli (yuav tsum tau sau npe ua ntej) ntawm CHA, coj los ntawm cov kws paub txog tshuaj geriatric ntawm University of California, Irvine. CHA yog ib qho kev tshuaj ntsuam xyuas dementia uas yuav tsum tau ua rau cov neeg laus laus thaum twg qhov kev ntsuam xyuas kev txawj ntse raug qhia. Kev cob qhia tom ntej yuav muaj rau lub Rau Hli 2. Cov kws kho mob thiab pab pawg tuaj yeem koom nrog peb hauv thawj zaug thiab thib peb hnub Friday ntawm txhua lub hlis kom paub ntau ntxiv txog yuav ua li cas CHA tuaj yeem txhawb nqa cov kws kho mob thiab lawv pab pawg kom kuaj pom kev dementia zoo dua hauv lawv cov neeg mob. Muaj kev kawm kho mob txuas ntxiv dawb thiab chav kawm txuas ntxiv.​​  

Pawg Neeg Saib Xyuas Kev Noj Qab Haus Huv thiab Khab Cov Neeg Sawv Cev Sib Tham Virtual​​  

On May 22, from 9:30 a.m. to 12 p.m., DHCS will host the quarterly Tribal and Indian Health Program representatives’ virtual meeting (advance registration required). This webinar will include a discussion of DHCS programs and initiatives of interest to tribal partners, and offer a forum to provide feedback on specific aspects of DHCS initiatives that directly affect tribes, Indian Health Programs, and American Indian Medi-Cal members. The next meeting will be held in August in Sacramento. The meeting agenda and other materials will be posted on the Indian Health Program webpage as they become available.​​  

Stakeholder Advisory Committee (SAC) thiab Behavioral Health Stakeholder Advisory Committee (BH-SAC) Lub Rooj Sib Tham  ​​  

Thaum Lub Tsib Hlis 24, thaum 9:30 teev sawv ntxov txog 3:30 teev tsaus ntuj, DHCS yuav tuav lub rooj sib tham SAC thiab BH-SAC hybrid (yuav tsum tau sau npe ua ntej). Nws yuav qhib raws li lub rooj sib tham sib koom ua ke, nrog cov ncauj lus qhia los ntawm SAC thiab BH-SAC. Yuav muaj lub rooj sib tham BH-SAC nkaus xwb tom qab lub rooj sib tham sib koom ua ke; tsis muaj lub rooj sib tham SAC nkaus xwb. Cov neeg tuaj koom tuaj yeem tuaj koom tau zoo lossis nyob ntawm tus kheej ntawm California Endowment, nyob ntawm 1414 K Street hauv Sacramento. Yog xav paub ntxiv, thov mus saib ntawm SAC thiab BH-SAC lub vev xaib. ​​  

Pawg Sib Tham: Tsim Kev Sib Koom Tes rau Kev Tshaj Tawm Txhim Kho Kev Tswj Xyuas (ECM) rau Cov Me Nyuam thiab Cov Hluas​​  

Thaum Lub Rau Hli 23, thaum 1 txog 2:30 teev tsaus ntuj, DHCS yuav tuav ib qho kev tshwm sim virtual (yuav tsum tau sau npe ua ntej) ntawm lub zeem muag rau Kev Tswj Xyuas Kev Txhim Kho (ECM) rau cov menyuam yaus thiab cov hluas, ua ntej tshaj tawm ECM rau Cov Menyuam yaus thiab Cov Hluas Kev Pom Zoo (POF) thaum Lub Xya Hli 1. DHCS cov thawj coj yuav koom nrog pawg neeg muab kev pabcuam, cov koom haum hauv zej zog (CBOs), thiab cov phiaj xwm saib xyuas kev tswj hwm (MCPs) los muab:​​  

  • Kev ceeb toom ntawm kev tsim thiab kev taw qhia kev ua haujlwm rau Cov Me Nyuam thiab Cov Hluas POFs.​​  
  • Piv txwv ntawm yuav ua li cas cov kws kho mob tab tom npaj tsim ECM rau Cov Me Nyuam thiab Cov Hluas POFs.​​  
  • Kev taw qhia rau MCPs, lub nroog, thiab lwm tus neeg muab kev pabcuam ntawm kev cog lus rau ECM cov txiaj ntsig.​​      

Qhov webinar no qhib rau pej xeem, thiab cov neeg tuaj koom yuav muaj sijhawm los nug cov lus nug thaum lub sijhawm sib tham. Nws yuav muaj kev txaus siab tshwj xeeb rau MCPs thiab cov neeg muab kev pabcuam ua haujlwm nrog menyuam yaus thiab cov hluas uas tau txais kev cog lus tshiab nrog MCPs, suav nrog cov nroog thiab CBOs. Thov xa cov lus nug mus rau CalAIMECMILOS@dhcs.ca.gov tsis pub dhau Lub Rau Hli 19.​​   

Hauv Case Koj Tsis Tau Nws​​  

California Awards Millions to Strengthen State’s Opioid Response​​  

On May 19, DHCS awarded more than $12 million in grants to strengthen the state’s opioid response as part of the California’s $1 billion plan to tackle the opioid epidemic. The awards include $7.9 million to 20 DHCS-licensed, residential substance use disorder (SUD) treatment facilities throughout the state as part of the Medication Assisted Treatment (MAT) Expansion Project, $3.5 million to 23 organizations through the Tribal Urban Indian Defined Best Practice program, and $1.05 million to seven organizations through the California Native MAT Network for Healing and Recovery.​​