December 15, 2023 – Stakeholder News
Xov xwm tshaj plaws
Managed Care Organization (MCO) Tax Federal pom zoo
Niaj hnub no Lub Chaw rau Medicare & Medicaid Services (CMS) tau pom zoo rau MCO Tax tsoom fwv zam zam, paving txoj hauv kev rau DHCS mus rau pem hauv ntej nrog kev siv MCO Tax rau lub sij hawm tau tso cai, raug rau yav tom ntej cov kev hloov nyob rau hauv tsoom fwv teb chaws txoj cai hais txog kev noj qab haus huv cov se.
Assembly Bill 119 (Chapter 13, Statutes of 2023) tso cai rau MCO Tax pib txij lub Plaub Hlis 1, 2023, mus txog lub Kaum Ob Hlis 31, 2026. MCO Tax tau kwv yees tias yuav muab $ 19.4 nphom hauv cov nyiaj tsis yog tsoomfwv hauv lub sijhawm 3.75 xyoo. Raws li kev pom zoo thiab tsoomfwv pom zoo rau cov qauv kev them nyiaj thiab tus nqi, MCO cov nyiaj tau los yuav raug siv los txhawb Medi-Cal qhov kev pab cuam suav nrog, tab sis tsis txwv rau, tus kws kho mob cov nqi nce thiab lwm yam kev nqis peev uas ua rau nkag mus tau zoo, zoo, thiab kev ncaj ncees rau Medi-Cal cov tswv cuab thiab txhawb nqa kev koom tes hauv Medi-Cal qhov kev pab cuam.
Raws li lub xeev txoj cai lij choj, DHCS yuav tau lees paub hauv cov hnub sau ntawv tias tsoomfwv tau txais kev pom zoo thiab tshaj tawm cov ntawv ceeb toom rau txhua tus MCO uas raug them se uas qhia txog cov se uas tau them rau txhua lub sijhawm se thiab cov hnub uas yuav them se se tawm. Tsis tas li ntawd, DHCS yuav tshaj tawm hauv nws lub vev xaib cov ntaub ntawv ntsig txog MCO Tax, suav nrog tsab ntawv pom zoo, cov nqi se uas yuav tsum tau them rau txhua lub sijhawm se, thiab lwm yam ntaub ntawv tseem ceeb. Ib qhov txuas mus rau qhov chaw ntawm cov peev txheej no yuav muab rau hauv kev hloov tshiab rau cov neeg koom nrog yav tom ntej.
Hloov Kho Kev Pabcuam Sijhawm Ntev thiab Kev Txhawb (LTSS) Cov Ntaub Ntawv Dashboard
DHCS today released an updated LTSS data dashboard that features additional measures and improves data transparency and accessibility. As the state drives significant improvements in quality and health equity for Medi-Cal members, the LTSS data dashboard reports utilization and demographic data of long-term services and supports provided by counties and Medi-Cal managed care plans (MCP). It will allow users to explore trends across services and subpopulations throughout California.
The new December 2023 LTSS data dashboard includes data from 2017 through 2022 and features 16 additional utilization measures for home health services, the California Community Transitions project, and services utilized by Californians with developmental disabilities. The LTSS data dashboard will be updated biannually, future iterations will include additional cost and quality measures, and data will demonstrate progress toward “rebalancing” LTSS away from institutional care toward home and community-based services.
Kev hloov kho tshiab
DHCS 2023 Legislative Summary Report
DHCS today released the 2023 Legislative Summary report. This report provides a summary of chaptered and vetoed legislation for all significant bills the Department analyzed and engaged with during the first year of the 2023-2024 legislative session. Please note, this report does not represent a complete listing of bills the Department followed, nor any bills that did not make it to the Governor’s desk.
Hnub nyoog 26-49 Tus Neeg Laus F ull Scope Medi-Cal Expansion Implementation
Thaum Lub Kaum Ob Hlis Ntuj 11, 2023, DHCS tau muab ntawv pov thawj ntawm kev npaj ua haujlwm rau Lub Tsev Haujlwm Saib Xyuas Nyiaj Txiag los siv Lub Hnub nyoog 26-49 Tus Neeg Loj Loj. Lub Hnub nyoog 26-49 Tus Neeg Laus Tshaj Tawm yuav muab cov tib neeg muaj hnub nyoog 26-49 xyoo nrog tag nrho cov txiaj ntsig Medi-Cal tsis hais txog kev nkag tebchaws, yog tias lawv ua tau raws li tag nrho lwm yam kev tsim nyog tau txais Medi-Cal. DHCS yuav ua kom tiav qhov kev hloov pauv ntawm Hnub Nyoog 26-49 Cov Neeg Laus Loj Tshaj Plaws hauv cov kev txwv Medi-Cal kom puv Medi-Cal pib txij Lub Ib Hlis 1, 2024. Cov ntawv ceeb toom ntawm Kev Ua Haujlwm tau raug xa mus rau cov neeg raug cuam tshuam kom ceeb toom lawv txog lawv txoj kev hloov pauv mus rau tag nrho Medi-Cal txij thaum Lub Ib Hlis 1, 2024.
Yog xav paub ntxiv txog Hnub Nyoog 26-49 Adult Expansion, thov mus saib Lub Hnub nyoog 26-49 Adult Expansion Webpage. Yog xav paub ntxiv txog Hnub Nyoog 26-49 Adult Expansion, thov email rau AdultExpansion@dhcs.ca.gov.
Cov Kev Xaiv Hauv Tsev thiab Hauv Zej Zos (HCBA) Qhov Kev Zam Txim Ntxiv Ntxiv Kev Pom Zoo
On December 11, the federal Centers for Medicare & Medicaid Services (CMS) approved DHCS’ amendment to the HCBA Waiver adding slot capacity to the waiver for waiver years two through five (2024 – 2027). The waiver amendment approval is effective January 1, 2024, coinciding with the start of waiver year two (January 1, 2024 – December 31, 2024). The approved waiver amendment adds 1,800 additional waiver slots for each of the remaining four waiver years for a total increase in waiver capacity of 7,200 slots during the course of the waiver term. For additional information, including the approved waiver, visit the HCBA waiver webpage.
Tsev Muab Kev Nkag Mus Nkag thiab Hloov Kho Kev Noj Qab Haus Huv (PATH) Peev Xwm thiab Cov Txheej Txheem Kev Hloov Pauv, Kev nthuav dav, thiab Kev Txhim Kho (CITED) Round 3 Daim Ntawv Thov Daim Ntawv Qhia Muaj Lub Kaum Ob Hlis 18
On December 18, 2023, DHCS will publish the PATH CITED Round 3 application outline to help prospective applicants prepare the resources and information required to complete their application prior to the opening of the funding window on January 15, 2023. The CITED Round 3 application window is expected to open on the PATH CITED website for 30 days, from January 15 through February 15, 2024. The application outline is intended to be used as a planning tool and intended to “preview” the application. It is not the formal application. Applicants are still required to apply for CITED Round 3 funding using the application link on the PATH CITED website.
The PATH CITED initiative provides funding to enable the transition, expansion, and development of Enhanced Care Management (ECM) and Community Supports capacity and infrastructure. Round 3 eligible entities include community-based organizations; county, city, or local government agencies; federally qualified health centers; Medi-Cal Tribal and Designee of Indian Health Program; providers; and others as approved by DHCS. Visit the PATH CITED website to learn more.
Medi-Cal Hloov Kho Tshiab
DHCS niaj hnub no tau tshaj tawm lub Kaum Hlis 2023 Medi-Cal qhov kev pab cuam tas li unwinding kev tsim nyog ntsuas cov ntaub ntawv nyob rau hauv Medi-Cal Enrollment and Renewal Data webpage. Lub Kaum Hli Ntuj dashboard suav nrog cov ntaub ntawv ntawm Medi-Cal rau npe, cov ntawv thov kev ua tiav, kev txiav txim siab rov qab, thiab kev rho npe. Cov ntaub ntawv tseem suav nrog cov ntaub ntawv pej xeem rau txhua qhov kev txiav txim siab rov qab, nrog rau cov laj thawj saum toj kawg nkaus rau kev rho npe.
Koom nrog peb pab neeg
DHCS tab tom ntiav. DHCS muaj cib fim rau:
- Assistant Deputy Director for Program Operations assists in leading, planning, organizing, and directing Program Operations, which is comprised of the California Medicaid Management Information System – Operations, Clinical Assurance, Provider Enrollment, and Third-Party Liability and Recovery Divisions. (Final filing date (FFD) is December 29)
- Chief of Capitated Rates Development within Health Care Financing serves as the principal policymaker for all rate-setting activities to ensure high-quality and cost-efficient health care through DHCS’ contracted Medi-Cal MCPs. (FFD is December 19)
- Tus Thawj Saib Xyuas Tus Nqi-rau-Kev Pabcuam Kev Loj Hlob hauv Kev Pabcuam Kev Noj Qab Haus Huv tau tsim, txhais, thiab teeb meem txoj cai ntawm Medi-Cal cov txheej txheem them rov qab rau Medi-Cal tus nqi-rau-kev pabcuam (FFS) cov kev pabcuam uas tsis yog lub tsev haujlwm thiab mus sij hawm ntev thiab cov kev pabcuam them nqi khomob. (FFD) yog lub Kaum Ob Hlis 20)
DHCS tseem tab tom ntiav rau peb cov peev txheej tib neeg, kev tshuaj xyuas, txoj cai tswjfwm kev noj qab haus huv, kev siv thev naus laus zis, thiab lwm pab pawg. Yog xav paub ntxiv, thov mus saib hauv CalCareers lub vev xaib.
Cov Rooj Sib Tham Cov Neeg Koom Tes thiab Webinar yuav los tom ntej
Txhim Kho Kev Tswj Xyuas (ECM) thiab Zej Zog Txhawb Kev Kho Mob Cov Txheej Txheem Txheej Txheem Txheej Txheem (HCPCS) Coding Guidance Webinar
Thaum Lub Kaum Ob Hlis 18, thaum 11 teev sawv ntxov txog 12 teev tsaus ntuj, DHCS yuav tuav lub vev xaib los muab cov ntsiab lus ntawm cov kev hloov tshiab tsis ntev los no rau ECM thiab Community Supports HCPCS Coding Guidance (yuav tsum tau sau npe ua ntej). DHCS tau pib tshaj tawm cov lus qhia hauv 2021 uas suav nrog HCPCS cov lej thiab cov kev hloov pauv uas yuav tsum tau siv los tshaj tawm thiab sau nqi rau ECM thiab Kev Pabcuam Zej Zog ntsib kev sib ntsib. Qhov no suav nrog cov ntaub ntawv ntsib uas ECM thiab Community Supports cov chaw muab kev pabcuam xa mus rau MCPs rau kev thov lossis kev them nqi, thiab MCPs xa mus rau DHCS los saib xyuas kev ua haujlwm thiab kev ncaj ncees. Raws li kev tawm tswv yim xa los ntawm cov neeg muaj feem cuam tshuam thoob plaws lub xyoo thaum ntxov ntawm ECM thiab Kev Txhawb Zej Zog Kev Ua Haujlwm, DHCS tau hloov kho cov lus qhia no kom nce qib ntawm cov ntaub ntawv thoob plaws lub xeev thiab yooj yim rau kev tswj hwm lub nra.
Tshwj xeeb tshaj yog, DHCS tau ntxiv ECM tshiab thiab Zej Zog Txhawb HCPCS cov lej / hloov pauv kev sib txuas thiab ua tiav cov kev xav tau uas MCPs yuav tsis xav tau lossis tso cai rau lawv cov neeg muab kev pabcuam los tshaj tawm cov lej lossis hloov kho rau ECM thiab Cov Kev Pabcuam Hauv Zej Zos tshaj li tau teev tseg los ntawm DHCS hauv kev taw qhia. Qhov webinar no yuav muab MCPs, ECM thiab Community Supports cov chaw muab kev pab, thiab lwm cov neeg muaj feem txaus siab rau lub sijhawm los kawm ntxiv thiab nug cov lus nug txog cov kev hloov tshiab uas tau ua rau ECM thiab Community Supports HCPCS coding guidance.
Telehealth Stakeholder Advisory Group Informational Webinar
Thaum Lub Kaum Ob Hlis 19, txij li 10 txog 11 teev sawv ntxov, DHCS yuav tuav ib qho kev qhia hauv webinar rau Telehealth Stakeholder Advisory Group thiab thov kev tawm tswv yim txog kev hloov tshiab DHCS tau ua tiav rau Medi-Cal Tus Muab Kev Pab Cuam: Telehealth ntsig txog Tus Neeg Mob Kev Xaiv ntawm Telehealth Modality thiab Txoj Cai rau Kev Pabcuam Hauv Tus Neeg. DHCS cia siab tias cov kev hloov tshiab no yuav raug tshaj tawm rau lub caij nplooj ntoos hlav 2024. Cov kev hloov tshiab ua tau raws li qhov yuav tsum tau tsim nyob rau hauv Senate Bill 184 (Tshooj 47, Txoj Cai ntawm 2022) thiab Assembly Bill 1241 (Tshooj 172, Txoj Cai ntawm 2023). Ua raws li qhov webinar, DHCS yuav muab cov tswv cuab pab tswv yim nrog peb lub lis piam tawm tswv yim. Thov xa koj cov lus nug thiab cov lus pom rau pej xeem hauv email rau Medi-Cal_telehealth@dhcs.ca.gov.
Medi-Cal tus nqi nce Webinar
Thaum Lub Kaum Ob Hlis 19, DHCS yuav muaj kev sib tham hauv web los qhia cov ntaub ntawv nrog cov kws kho mob txog yuav ua li cas thiab thaum twg Medi-Cal tus nqi nce, pib lub Ib Hlis Ntuj 1, 2024, yuav raug muab coj los siv hauv Medi-Cal FFS thiab cov kev tswj xyuas kev noj qab haus huv. Thaum Lub Kaum Ob Hlis 1, DHCS tau tshaj tawm cov nqi FFS tshiab ntawm DHCS lub vev xaib.
Ua raws li Kev Noj Qab Haus Huv thiab Tsev Kawm Ntawv Txoj Cai Tshooj 14105.201, raws li tsoom fwv pom zoo, DHCS yuav nce FFS tus nqi rau cov txheej txheem phiaj xwm tsis pub tsawg dua 87.5 feem pua ntawm cov nqi Medicare. DHCS yuav coj Medi-Cal MCPs los xyuas kom meej tias cov nyiaj them lawv them rau cov chaw muab kev pabcuam hauv lub network rau cov txheej txheem cov txheej txheem tsis muaj tsawg dua li FFS cov nyiaj them rov qab tshiab. Cov kev pabcuam cuam tshuam yog cov kev pabcuam thawjcoj, suav nrog cov kws khomob thiab cov kws khomob uas tsis yog kws khomob, kev pabcuam obstetric thiab doula, thiab cov kev pabcuam kev puas hlwb uas tsis yog tshwj xeeb.
Thaum Lub Yim Hli 2023, DHCS tau hais kom pej xeem tawm tswv yim ntawm cov phiaj xwm txheej txheem teev npe thiab FFS tus nqi nce cov txheej txheem, thiab nyob rau lub Cuaj Hli tau xa Xeev Txoj Kev Hloov Kho 23-0035 rau CMS. Tsis tas li ntawd, DHCS tau koom tes nrog ib pab pawg neeg ua haujlwm hauv MCP los txhim kho yuav ua li cas qhov kev cia siab ntawm kev them nyiaj tshiab (kev npaj them nyiaj ncaj qha) yuav ua haujlwm nyob rau hauv kev tswj xyuas tus me nyuam. Vim qhov xav tau ntawm MCPs los hloov kho lawv cov kab ke thiab cov ntawv cog lus hauv chaw kho mob, cov nqi nce ntxiv yuav tsis raug them rau hauv kev tswj hwm kev saib xyuas tam sim ntawd. DHCS yuav tsim kev cai, los ntawm kev sau ntawv qhia, lub sijhawm ua raws li MCPs kom ua tiav cov qib kev them nyiaj nce ntxiv, raws li tsim nyog, raws li kev mus tom ntej thiab rov qab mus rau Lub Ib Hlis 1, 2024.
Yog xav paub ntxiv txog qhov webinar, lossis yog tias koj muaj lus nug lossis lus nug, thov email TargetedRateIncreases@dhcs.ca.gov.
Hearing Aid Coverage for Children Program (HACCP) Webinar rau Cov Kws Kho Mob thiab Cov Kws Kho Hniav
Thaum Lub Kaum Ob Hlis 19, txij li 12 txog 1 teev tsaus ntuj, DHCS yuav tuav HACCP webinar (yuav tsum tau sau npe ua ntej) los qhia cov ntaub ntawv nrog cov kws kho mob los pab cov neeg mob me thiab lawv tsev neeg kom tau txais txiaj ntsig HACCP ntau tshaj plaws. Kev cob qhia yuav hais txog cov kev xav tau ntawm cov tsev neeg los thov kev pab them nqi thiab cov txheej txheem xa ntawv thov rau audiologists, otolaryngologists, kws kho mob, thiab lawv cov neeg ua haujlwm hauv chaw ua haujlwm. Yog xav paub ntxiv, thov mus saib hauv www.dhcs.ca.gov/haccp.
Hauv Case Koj Tsis Tau Nws
California Launches New Opioid Resource Website
California launched a new, comprehensive opioid website that gives Californians a single resource for prevention, data, treatment, and support information. The website, OPIOIDS.CA.GOV, is part of Governor Newsom’s multi-pronged approach to connect Californians with information to prevent and reduce overdoses and deaths and support those struggling with substance use and addiction.
All Californians should visit OPIOIDS.CA.GOV to learn more and help us spread awareness and save lives. Together we can make a difference in combating this crisis.
We are also interested in hearing feedback from our partners about this new resource as we continue to iterate and improve the website. Please share your thoughts or comments with us at CommsOutreach@cdph.ca.gov.
Lub Ib Hlis 2024 Medi-Cal MCP Kev Hloov Pauv
As part of Medi-Cal transformation, some MCPs are changing on January 1, 2024, and approximately 1.2 million members will have new health plan options and/or will need to transition to new MCPs. Changing MCPs will not affect Medi-Cal member coverage or benefits. Members transitioning to a new MCP received notices about the transition. DHCS developed several resources to support members, providers, and other stakeholders with the transition, including the Managed Care Plan Transition Member webpage with a county “lookup” tool, links to member notices sent by Medi-Cal about MCP changes, frequently asked questions, and a Contact Us page for members to learn more about health plans and provider choices. There are also transition resources for providers and MCPs and stakeholders. More information about the transition is available in the 2024 Managed Care Plan Transition Policy Guide and Medi-Cal Eligibility Division Information Letter Number I 23-54.