Hla mus rau Cov Ntsiab Lus Tseem Ceeb​​ 

Tsoom Fwv Teb Chaws Tswj Kev Tswj Xyuas Kev Tswj Xyuas​​ 

Keeb kwm​​ 

Thaum Lub Plaub Hlis 25, 2016, Lub Chaw rau Medicare & Medicaid Services (CMS) tau tshaj tawm Medicaid thiab CHIP Managed Care Final Rule (2016 Final Rule), uas ua raws li Medicaid tswj kev pab cuam nrog rau lwm cov kev pab them nqi kho mob hauv ntau qhov tseem ceeb:​​ 

  • Modernizes li cas lub xeev yuav tswj kev saib xyuas rau cov neeg tau txais txiaj ntsig;​​ 
  • Ntxiv kev tiv thaiv cov neeg siv khoom tseem ceeb los txhim kho kev saib xyuas zoo thiab kev paub txog cov neeg tau txais txiaj ntsig; thiab​​ 
  • Txhim kho lub xeev lav ris thiab pob tshab.​​  
Txoj Cai Kawg 2016 yog thawj qhov kev hloov kho tseem ceeb ntawm tsoomfwv Medicaid tswj kev saib xyuas txij li xyoo 2002, thiab yog cov lus teb rau kev hloov pauv tseem ceeb rau Medicaid tswj kev saib xyuas kev noj qab haus huv tshwm sim thoob tebchaws. Txoj Cai Kawg 2016 tau siv rau Lub Xya Hli 5, 2016 nrog rau kev ua tiav ntau xyoo. 
 
Hauv California, Txoj Cai Lij Choj Kawg 2016 muaj feem xyuam rau Medi-Cal Managed Care Plans, County Mental Health Plans, Drug Medi-Cal Organized Delivery System, thiab Dental Managed Care Plans. Nplooj ntawv no muaj cov kev xav tau tshaj tawm rau Txoj Cai Zoo, Kev Tsim Nyog Network, thiab Mental Health Parity Cheebtsam ntawm 2016 Txoj Cai Kawg.​​ 
 
Thaum Lub Kaum Ib Hlis 14, 2018, CMS tau tshaj tawm tsab ntawv ceeb toom ntawm kev tsim cai lij choj (NPRM) hu ua "Medicaid Program; Medicaid thiab Children's Health Insurance Plan (CHIP) Managed Care." Thaum Lub Ib Hlis 14, 2019, DHCS tau xa tsab ntawv tawm tswv yim rau CMS ntawm NPRM.​​ 
 
 

Cov Neeg Siv Khoom Portal
​​ 

Lub portal no muab kev txhawb nqa rau cov neeg tau txais txiaj ntsig ob qho tib si ua ntej thiab tom qab tso npe hauv kev kho mob thiab kev kho hniav kho hniav.​​ 

Tswj Kev Tswj Xyuas Zoo Zoo​​       

Txoj Cai Zaum Kawg xav kom txhua lub xeev Medicaid lub koom haum ua raws li cov tswv yim sau zoo los ntsuam xyuas thiab txhim kho cov kev kho mob thiab cov kev pab zoo uas muaj los ntawm txhua lub koom haum Medicaid tswj hwm hauv lub xeev.​​ 

Network txaus​​ 

Txhawm rau ntxiv dag zog rau kev nkag mus rau cov kev pabcuam hauv lub network uas tswj hwm kev saib xyuas, Txoj Cai Kawg xav kom cov xeev tsim kom muaj cov qauv tsim nyog hauv lub network hauv Medicaid tswj kev saib xyuas rau cov neeg muab kev pabcuam tseem ceeb, thaum tawm hauv lub xeev kom hloov tau cov qauv tseeb.​​ 

Mental Health Parity​​ 

Thaum Lub Peb Hlis 29, 2016, CMS tau tshaj tawm tsab cai Medicaid Mental Health Parity Final Rule (Parity Rule) los txhawb kev nkag mus rau kev mob hlwb thiab kev siv tshuaj yeeb dawb rau cov neeg tau txais txiaj ntsig Medicaid. Txoj Cai Parity yog tsim los tsim kom muaj kev sib xws ntawm kev lag luam thiab Medicaid kev lag luam.​​  

Cov peev txheej ntxiv​​                               

Hnub hloov tshiab kawg: 9/16/2025 3:34 PM​​