DHCS Stakeholder Update – March 3, 2023
Top News
End of the Public Health Emergency (PHE): Key Medicaid and Children’s Health Insurance Program (CHIP) Dates
The announcement that the federal COVID-19 PHE will end on May 11, 2023, has implications for Medicaid and CHIP programs. Additionally, DHCS is acting to make permanent several flexibilities implemented over the course of the PHE. Below is a summary of end dates for key federal Medicaid provisions, with additional details on how DHCS is unwinding the PHE in the Medi-Cal program.
Hais txog Medicaid thiab CHIP COVID-19 cov kev cai raws li American Rescue Plan Act (ARPA):
Optional COVID-19 Group for Uninsured Individuals: California has taken advantage of the “optional COVID-19 group” that provides uninsured individuals with Medi-Cal coverage for COVID-19 vaccines, testing, and treatment. This coverage expires on the last day of the PHE (May 11). In order to prepare individuals in this group for the end of the PHE, DHCS will send member notices on April 24, 2023.
No-Cost Coverage for COVID-19 Vaccines, Testing, and Treatment to Members: Medicaid is required to cover COVID-19 vaccines, testing, and treatment with no cost-sharing for members through the last day of the first calendar quarter that begins one year after the last day of the COVID-19 PHE. DHCS is electing to permanently extend coverage for COVID-19 vaccines, testing, and treatment at no cost beyond the ARPA coverage period.
Enhanced Federal Match for COVID-19 Vaccines and Vaccine Administration: States receive 100 percent federal matching funds for coverage of vaccines and vaccine administration, as enacted by ARPA. These matching funds also end on the last day of the first calendar quarter that begins one year after the last day of the COVID-19 PHE (September 30, 2024). As described above, Medi-Cal will continue to cover COVID-19 vaccine and vaccine administration.
Hais txog txoj cai flexibilities ua tau los ntawm PHE:
Section 1135 waivers expire at the end of the PHE (May 11). Medicaid programs are unable to extend flexibilities authorized under 1135 waivers. Additionally, DHCS is electing to discontinue emergency Medi-Cal provider enrollment flexibilities, effective March 29, 2023, as recently announced.
Medicaid Disaster Relief State Plan Amendments (SPAs) typically expire at the end of the PHE (May 11), but DHCS is making permanent many policies authorized under Disaster Relief SPAs. For details on the specific policies that are being made permanent through the traditional SPA process, please see Part I of the Medi-Cal COVID-19 PHE and Continuous Coverage Operational Unwinding Plan.
Section 1915(c) Appendix K or Section 1115 Attachment K termination dates vary by waiver, but typically will be no later than six months after the end of the PHE. Similarly, DHCS intends to make some 1915(c) and 1115 flexibilities permanent Medi-Cal policies beyond the end of the PHE. For details on these policies, please see part I of the Medi-Cal COVID-19 PHE and Continuous Coverage Operational Unwinding Plan.
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Tam sim no Qhib: Muab Kev Nkag Mus Nkag thiab Hloov Kho Kev Noj Qab Haus Huv (PATH) Technical Assistance (TA) Daim Ntawv Thov Kev Lag Luam
On February 27, DHCS opened the PATH TA Marketplace Project Eligibility Application. Medi-Cal service providers who submitted the Recipient Registration Form and have been approved as a TA recipient may now shop and apply for no-cost TA services through the Marketplace. TA services are being offered by an initial selection of 47 unique vendors. They will assist providers, community-based organizations (CBOs), Medi-Cal Tribal and Designees of Indian Health Programs, counties, and other eligible TA recipients build and deliver successful Enhanced Care Management and Community Supports. To learn more, visit ca-path.com/ta-marketplace.
PATH Capacity and Infrastructure Transition, Expansion, and Development (CITED) Round 2 Application Now Open
On February 28, DHCS opened the PATH CITED Round 2 application window. The PATH CITED initiative provides funding to on-the-ground partners, such as CBOs, public hospitals, county agencies, Tribes, and others to help them successfully participate in the Medi-Cal delivery system. New companies are encouraged to become Medi-Cal providers to deliver Enhanced Care Management and Community Supports. Entities interested in applying for Round 2 are encouraged to join the upcoming informational webinar on March 3, from 10 to 11 a.m., to learn more about CITED funds and the application process. The deadline to apply for CITED Round 2 funding is May 31, 2023.
Please visit ca-path.com/cited to apply and for more information. For questions, please email cited@ca-path.com.
Hearing Aid Coverage for Children Program (HACCP) Action Plan and Communications Toolkit
On March 1, DHCS released the HACCP Action Plan, which provides an overview of DHCS’ comprehensive strategy on HACCP improvements in 2023 with actionable tactics to improve provider participation and increase program enrollment.
Also, on February 28, DHCS published the HACCP Communications Toolkit and Program Data dashboard to support these objectives. The toolkit includes social media messaging and printable outreach materials for HACCP-eligible families and medical providers, and DHCS’ HACCP Program Data webpage. Additional program information is available at DHCS’ HACCP webpage.
Monkeypox (Mpox) Vaccine Administration
Lub Chaw rau Medicare & Medicaid Services (CMS) tsis ntev los no tau pom zoo SPA 22-0062 kom them nyiaj rov qab rau Tsoom Fwv Saib Xyuas Kev Noj Qab Haus Huv (FQHCs), Cov Chaw Kho Mob Hauv Nroog (RHCs), Indian Kev Pabcuam Kev Noj Qab Haus Huv Memorandum of Agreement (IHS-MOA,) thiab Tribal FQHC cov chaw kho mob ntawm tus nqi-rau-kev pabcuam (FF. Nws yog rov qab mus rau lub Yim Hli 17, 2022, thiab txuas ntxiv mus txog qhov kawg ntawm Mpox lub xeev kev noj qab haus huv xwm txheej ceev (Lub Ib Hlis 31, 2023).
Mpox vaccines administered during a qualifying office visit to eligible providers are entitled to reimbursement at their individual Prospective Payment System or All-Inclusive rates. Providers are reminded that each administration of the Mpox vaccine either falls under a qualifying office visit or vaccine-only encounter, not both. Eligible providers may begin submitting claims for members enrolled in Medi-Cal managed care plans for Mpox vaccine-only encounters. Effective March 10, 2023, providers may submit claims for FFS members pursuant to instructions published in the December 13, 2022, article “Mpox Vaccines Reimbursement at the Medicare Rate”. Providers will receive a 120-day timeliness override to submit the Mpox vaccine-only encounters.
Medi-Cal Rx
Thaum Lub Ob Hlis 24, 2023, Phase II, Wave 2 ntawm Medi-Cal Rx Reinstatement Plan tau ua tiav tiav. Cov kws kho mob yuav tsum xa daim ntawv tso cai ua ntej rau 46 chav kawm tshuaj ntxiv, suav nrog cov khoom siv kho mob, thiab cov tshuaj pib tshiab rau cov tswv cuab hnub nyoog 22 xyoos thiab laus dua.
A 30-day countdown alert, entitled Phase III Lift 1: Retirement of the Transition Policy for Beneficiaries 22 Years of Age and Older, was also released to announce the next phase of the Medi-Cal Rx Reinstatement Plan. This is a reminder that Medi-Cal Rx will initiate the first of a series of transition policy lifts for members ages 22 and older starting on March 24, 2023.
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DHCS is hiring for our fiscal, human resources, legal, auditing, health policy, and information technology teams. For more information, please visit the CalCareers website.
DHCS tau mob siab rau kev khaws cia thiab txhim kho tag nrho cov kev noj qab haus huv thiab kev noj qab haus huv ntawm txhua tus neeg California.
DHCS lub luag haujlwm yog los muab cov neeg nyob hauv lub xeev uas muaj kev pheej hmoo siab tshaj plaws kom muaj kev ncaj ncees rau kev pheej yig, kev sib koom ua ke, kev saib xyuas kev noj qab haus huv zoo, thiab tam sim no tab tom hloov kho Medi-Cal kev pab cuam kom paub tseeb tias nws muab kev saib xyuas cov neeg California xav tau kev noj qab haus huv, lub neej zoo siab dua.
Cov Rooj Sib Tham Cov Neeg Koom Tes thiab Webinar yuav los tom ntej
Lub Chaw Saib Xyuas Kev Noj Qab Haus Huv Nyiaj Txiag Kev Hloov Kho Webinar
On March 10, from 1:30 to 2:30 p.m., DHCS will host a stakeholder webinar (advance registration required) to discuss the development of the Workforce Standards Program and present an update on the Workforce and Quality Incentive Program. Additional information is posted on the Nursing Facility Financing Reform (AB 186) webpage.
Hauv Case Koj Tsis Tau Nws
California Awards $4.6 Million to Emergency Departments (EDs) to Train Behavioral Health Navigators
On March 1, DHCS awarded more than $4.6 million to 39 hospitals with EDs, each receiving $120,000 to train behavioral health navigators to help expand access to substance use disorder and mental health services. The awards are part of DHCS’ CalBridge Behavioral Health Navigator Program. CalBridge is funded by the American Rescue Plan Act of 2021 under key initiatives for Medi-Cal’s Home and Community-Based Services, and aims to train and expand the ED workforce to address the urgent need for behavioral health patient care. These awards are part of a larger effort by CalHHS to strengthen California’s health and human services workforce.