April 29. 2024 – Stakeholder Update
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On April 25 and 26, DHCS celebrated the addition of two new facilities that will provide lifesaving treatment for Californians with mental health and substance use disorders (SUD). Paving the Way Foundation in Los Angeles County and Center Point Drug Abuse Alternatives Center in Sonoma County are expanding behavioral health treatment and recovery options in their local communities. These are among the first of many community treatment sites supported by the Behavioral Health Continuum Infrastructure Program and are under construction now in 49 counties. Even more sites will be funded and built, thanks to recently approved Proposition 1 bonds.
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Effective April 30, Code 1 Diagnosis Requirement – Reject Code 80 claim utilization management (UM) edits will be implemented for members 22 years of age and older. Medi-Cal Rx will use diagnosis code(s) from the member’s Medi-Cal medical record to meet the Code 1 diagnosis restriction. Code 1 drugs are subject to prescription documentation requirements, and prescribers and pharmacy providers must document the treatment diagnosis and keep that information readily available for auditing purposes. Code 1 diagnosis requirements can be met in one of four ways: provide a diagnosis with the prescription, communicate the diagnosis verbally to the pharmacy provider, submit a prior authorization request with the diagnosis, or use an acceptable diagnosis code that is on file in the Medi-Cal data system. Members 21 years of age and younger are not impacted.
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On May 4, the Smile, California mobile dental van tour will stop in Huntington Park. During the event, individuals will have access to various dental services, such as exams, X-rays, cleaning, and fluoride applications. More information about Medi-Cal-covered dental services is available on the Smile, California website.
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Medi-Cal Children’s Health Advisory Panel (MCHAP)
On May 1, from 10 a.m. to 2 p.m., DHCS will hold the MCHAP hybrid meeting (advance registration required). MCHAP advises DHCS on policy and operational issues that affect children in Medi-Cal. The panel consists of a 15-member advisory body whose members include recognized stakeholders and experts in their fields, medical professionals, advocates, and parent members. If you are interested in receiving information about MCHAP meetings or have general inquiries, please email MCHAP@dhcs.ca.gov.
Consumer-Focused Stakeholder Workgroup (CFSW)
On May 3, from 10 to 11:30 a.m., DHCS will convene the CFSW, which provides stakeholders an opportunity to review and provide feedback on a variety of consumer messaging materials. The forum focuses on eligibility- and enrollment-related activities and strives to offer an open discussion on Medi-Cal policies and functionality. Meeting materials, including the meeting agenda, will be posted to the CFSW webpage no later than May 1. Please email your questions to DHCSCFSW@dhcs.ca.gov.
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Thaum lub Tsib Hlis 14, thaum 1 txog 3 teev tsaus ntuj, DHCS yuav tuav lub rooj sib tham Medi-Cal Dental Los Angeles. DHCS yuav qhia cov kev hloov tshiab thiab cov ntaub ntawv hais txog cov haujlwm tshiab thiab yav tom ntej. Lub rooj sib tham tseem muab cov neeg muaj feem cuam tshuam txog kev kho hniav nrog lub rooj sab laj los qhia tawm tswv yim nrog pab pawg Medi-Cal Dental uas tuaj yeem pab txhim kho kev xa cov kev pab kho qhov ncauj. Cov ntaub ntawv rooj sib tham yuav muab tso rau ntawm DHCS Medi-Cal Dental Los Angeles Stakeholder Meetings webpage. Cov ntaub ntawv ntxiv yuav muab tso rau ntawm nplooj ntawv web ua ntej lub rooj sib tham lossis sai li sai tau thaum lawv muaj. Thov xa email rau koj cov lus nug rau dental@dhcs.ca.gov.
Stakeholder Advisory Committee (SAC) / Behavioral Health (BH)-SAC Lub Rooj Sib Tham
On May 29, from 9:30 a.m. to 3 p.m., DHCS will convene the SAC/BH-SAC hybrid meeting (advance registration required). The meeting will include an update on Proposition 1 implementation. SAC provides DHCS with valuable input on ongoing California Advancing and Innovating Medi-Cal (CalAIM) implementation efforts, as well as helps DHCS further its efforts to provide high-quality, equitable care.
BH-SAC is a broad-based body that disseminates information and receives coordinated input regarding DHCS behavioral health activities. It was created as part of the ongoing DHCS effort to integrate behavioral health with the rest of the health care system and incorporates existing groups that have advised DHCS on behavioral health topics.
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On May 30 at 10 a.m., DHCS will host the CalAIM MLTSS and Duals Integration Workgroup virtual meeting (advance registration is required). The workgroup serves as a stakeholder collaboration hub for CalAIM MLTSS and integrated care for dual eligible members and allows stakeholders to provide feedback and share information about policy, operations, and strategy for upcoming changes to Medi-Cal and Medicare.
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Cov ntaub ntawv keeb kwm yav dhau, cov ntawv sau tseg, thiab cov ntaub ntawv kaw tseg ntawm pawg neeg ua haujlwm yav dhau los, nrog rau cov ntaub ntawv ntxiv txog pawg neeg ua haujlwm, tau tshaj tawm rau ntawm CalAIM MLTSS thiab Duals Integration Workgroup lub vev xaib. Rau cov lus nug lossis lus pom, thov email info@calduals.org.