Xov xwm tshaj plaws​​ 

Lub Sijhawm Kev Noj Qab Haus Huv Tus Cwj Pwm Hauv Tsev Kawm Ntawv tau tshaj tawm​​  

DHCS tau tshaj tawm cov nqi rau Children and Youth Behavioral Health Initiative (CYBHI) thoob plaws lub xeev cov nqi them ntau tus neeg. Raws li ib feem ntawm Governor Newsom's Master Plan for Kids' Mental Health thiab CYBHI, DHCS, koom tes nrog Department of Managed Health Care thiab California Department of Insurance, tab tom nthuav dav kev nkag mus rau cov kev pabcuam kev noj qab haus huv sab nraud hauv tsev kawm ntawv (lossis txuas nrog tsev kawm ntawv) rau cov tub ntxhais kawm.​​  

Daim ntawv teev nqi teev cov nqi tsawg kawg nkaus uas Medi-Cal managed care plans (MCPs) yuav tsum them rov qab rau cov koom haum kev kawm hauv zos (LEAs) thiab cov chaw muab kev pab cuam txuas nrog tsev kawm ntawv rau kev muab cov kev pabcuam kev noj qab haus huv rau tus tub ntxhais kawm hnub nyoog qis dua 26 xyoo ntawm lub tsev kawm ntawv. Cov chaw kawm ntawv yuav suav nrog cov chaw hauv tsev kawm ntawv, sab nraum tsev kawm ntawv, thiab cov chaw kho mob txawb. Daim ntawv teev nqi qhia txog cov lej them nqi, cov nqi, thiab cov hom kev pabcuam rau txhua hom kev pabcuam uas tuaj yeem them nqi raws li ib feem ntawm CYBHI cov kev pabcuam teem sijhawm them nqi. Lus Cim: Daim ntawv teev nqi tseem tab tom tos kev pom zoo ntawm Kev Hloov Kho Txoj Kev Npaj ntawm Lub Xeev los ntawm tsoomfwv Meskas Lub Chaw Pabcuam Medicare thiab Medicaid (CMS) thiab yuav hloov pauv.​​  

DHCS is phasing in the fee schedule starting in January 2024, when the first cohort of 47 LEAs (announced on December 1, 2023) will go live. The second cohort will go-live in July 2024 and the third cohort in January 2025. Under state law, Medi-Cal MCPs, Medi-Cal Fee-for-Service (FFS), commercial health plans, and disability insurers (collectively referred to as MCPs) are obligated to reimburse eligible school-linked providers, including LEAs and community-based providers contracted by or affiliated with designated by the LEA.​​  

Thov mus saib nplooj ntawv teev nqi CYBHI kom paub ntau ntxiv.​​ 

Kev hloov kho tshiab​​ 

Medi-Cal Lub Hom Phiaj Tus Muab Kev Pab Cuam Tshaj Tawm tau pom zoo​​  

Thaum Lub Kaum Ob Hlis 19, 2023, CMS tau pom zoo rau Txoj Cai Hloov Kho Txoj Kev Npaj Hauv Xeev (SPA) 23-0035, tso cai rau DHCS los muab kev nce tus nqi rau kev saib xyuas thawj zaug/kev saib xyuas dav dav, kev yug menyuam, doula, thiab cov kev pabcuam kev noj qab haus huv tsis yog tshwj xeeb uas siv tau txij li Lub Ib Hlis 1, 2024. Raws li Assembly Bill (AB) 118 (Tshooj 42, Statutes of 2023), DHCS tau nce tus nqi rau cov kev pabcuam tsom mus rau tsawg kawg 87.5 feem pua ntawm tus nqi Medicare, suav nrog kev tshem tawm AB 97 kev txo nqi them rau cov neeg muab kev pabcuam thiab kev koom ua ke ntawm Proposition 56 cov nyiaj them ntxiv rau hauv tus nqi pib.​​  

For more information, including the 2024 Targeted Rate Increase Fee Schedule and approved SPA 23-0035, please visit the Medi-Cal Targeted Provider Rate Increase webpage.​​  

Hospital Quality Assurance Fee (HQAF) Program VIII Pom Zoo​​  

On December 15, 2023, and December 19, 2023, CMS approved the HQAF SPA 23-0007, SPA 23-0008, and broad-based and uniformity tax waiver letter, respectively, authorizing the HQAF VIII program supplemental payments to be made to California private hospitals up to the aggregate upper payment limit for the period of January 1, 2023, through December 31, 2024.​​  

Lub HQAF program tau tsim muaj nyob rau xyoo 2009 nrog lub hom phiaj ntawm kev txhim kho kev them nyiaj rov qab rau tsev kho mob rau cov kev pabcuam uas tau muab rau cov tswv cuab Medi-Cal. Rau cov kev pabcuam uas tau muab rau lub xyoo 2023 thiab 2024, qhov kev pab cuam HQAF kwv yees tias yuav muab rau cov tsev kho mob ntiag tug kwv yees li $ 21 billion hauv kev them nyiaj ntxiv rau cov kev pabcuam hauv tsev kho mob thiab cov kev pabcuam sab nraud thiab kev them nyiaj ntxiv rau cov phiaj xwm kev saib xyuas. Tsis tas li ntawd xwb, qhov kev pab cuam no tsim nyiaj txiag rau kev them nqi kho mob rau menyuam yaus thiab cov nyiaj pab rau tsev kho mob pej xeem.​​   

DHCS yuav tshaj tawm cov ntaub ntawv ntsig txog HQAF VIII program hauv nws lub vev xaib, suav nrog SPA, Tus nqi thiab tus qauv them nyiaj, thiab lwm yam ntaub ntawv tseem ceeb. HQAF VIII yuav txuas ntxiv muab nyiaj txiag uas xav tau thiab txhim kho cov neeg tau txais Medi-Cal kom tau txais kev kho mob thoob plaws California. Yog xav paub ntxiv txog qhov kev pab cuam no, thov mus saib lub vev xaib HQAF, thiab thov xa email rau cov lus nug rau HQAF@dhcs.ca.gov.​​  

Cov peev txheej tshiab rau Medi-Medi Plan nthuav tawm​​  

DHCS released two new Sign-Language YouTube videos for members dually eligible for Medicare and Medi-Cal. Both videos are sign language interpretations: “Joining a Medi-Medi Plan” is in American Sign Language and “Inscibirse a un Plan de Medi-Medi” is in Mexican Sign Language.​​  

Cov neeg California hauv kaum ob lub nroog tsim nyog rau npe rau hauv Medicare-Medi-Cal Plans (Medi-Medi Plans), ib hom phiaj xwm Medicare Advantage hauv California uas tsuas yog muaj rau cov tswv cuab uas tsim nyog ob qho tib si. Cov phiaj xwm Medi-Medi muab kev saib xyuas ntau dua rau cov tib neeg uas tsim nyog tau txais Medicare thiab Medi-Cal, thiab cov txiaj ntsig hauv ob qho kev pab cuam yog sib koom tes los ntawm ib lub koom haum tswj hwm kev saib xyuas (MCO). Xyoo 2024, Medi-Medi Plans muaj nyob rau hauv cov nroog hauv qab no: Fresno, Kings, Los Angeles, Madera, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Mateo, Santa Clara, thiab Tulare.​​   

Cov ntaub ntawv ntxiv muaj nyob rau ntawm nplooj ntawv web DHCS Medi-Medi Plan.​​  

Muab Kev Nkag Mus Nkag thiab Hloov Kho Kev Noj Qab Haus Huv (PATH) Kev Muaj Peev Xwm thiab Cov Txheej Txheem Kev Hloov Pauv, Kev nthuav dav, thiab Kev Txhim Kho (CITED) Round 3 Daim Ntawv Thov tuaj sai sai​​  

Thaum Lub Ib Hlis Ntuj hnub tim 15, 2024, DHCS npaj yuav qhib lub qhov rais thov PATH CITED Round 3. Lub PATH CITED txoj haujlwm muab nyiaj txiag los tsim kom muaj peev xwm thiab cov khoom siv rau cov neeg koom tes hauv av uas xa cov txiaj ntsig Medi-Cal enhanced care management (ECM) thiab cov kev pabcuam txhawb nqa hauv zej zog. Lub sijhawm kawg rau kev thov nyiaj pab CITED Round 3 tam sim no tau teem tseg rau lub Ob Hlis 15, 2024.​​  

Thaum Lub Kaum Ob Hlis Ntuj hnub tim 18, 2023, DHCS tau tshaj tawm daim ntawv qhia txog daim ntawv thov PATH CITED Round 3 los pab cov neeg thov npaj cov peev txheej thiab cov ntaub ntawv xav tau los ua kom tiav lawv daim ntawv thov. Lub qhov rais thov CITED Round 3 yuav qhib rau lub Ib Hlis 15, 2024, rau 30 hnub. Cov chaw tsim nyog thib 3 suav nrog cov koom haum hauv zej zog; cov koom haum tsoomfwv hauv nroog, nroog, lossis hauv zos; cov chaw kho mob uas tau txais kev tso cai los ntawm tsoomfwv; Medi-Cal Tribal thiab Designee of Indian Health Program; cov chaw muab kev pab; thiab lwm tus raws li DHCS tau pom zoo. Mus saib lub vev xaib PATH CITED kom paub ntau ntxiv.​​  

Koom nrog peb pab neeg​​ 

DHCS tab tom ntiav. DHCS muaj cib fim rau:​​  

• Tus Lwm Thawj Coj rau Kev Ua Haujlwm ntawm Cov Kev Pabcuam pab coj, npaj, teeb tsa, thiab coj Kev Ua Haujlwm ntawm Cov Kev Pabcuam, uas muaj California Medicaid Management Information System - Kev Ua Haujlwm, Kev Lees Paub Txog Kev Kho Mob, Kev Sau Npe Rau Cov Kws Kho Mob, thiab Cov Chaw Haujlwm Saib Xyuas Kev Lav Phib Xaj thiab Kev Rov Qab Tau Nyiaj ntawm Sab Nraud. (Hnub kawg xa daim ntawv thov (FFD) yog Lub Kaum Ob Hlis 29)​​   
• Tus Thawj Coj ntawm Kev Txhim Kho Tus Nqi Capitated hauv Kev Pab Nyiaj Txiag Kev Kho Mob ua haujlwm ua tus tsim cai tseem ceeb rau txhua yam kev ua ub no teem tus nqi kom ntseeg tau tias kev kho mob zoo thiab siv nyiaj tau zoo los ntawm DHCS cov Medi-Cal MCPs uas tau cog lus. (FFD txuas ntxiv mus txog rau lub Kaum Ob Hlis 26)​​   
• 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 txuas ntxiv mus rau lub Kaum Ob Hlis 26)​​  

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.​​ 

Hauv Case Koj Tsis Tau Nws​​ 

TXOJ CAI LINK: DHCS 2023 Daim Ntawv Qhia Txog Kev Cai Lij Choj​​   

Thaum Lub Kaum Ob Hlis 15, DHCS tau tshaj tawm daim ntawv qhia txog Kev Cai Lij Choj Xyoo 2023 . Daim ntawv tshaj tawm no muab cov ntsiab lus luv luv ntawm cov kev cai lij choj uas tau muab faib ua pawg thiab tsis pom zoo rau txhua daim ntawv cai lij choj tseem ceeb uas Lub Chaw Haujlwm tau tshuaj xyuas thiab koom nrog thaum lub xyoo thawj zaug ntawm xyoo 2023-2024 kev sib tham txog kev cai lij choj. Thov nco ntsoov tias, daim ntawv tshaj tawm no tsis yog cov npe tag nrho ntawm cov nqi uas Lub Chaw Haujlwm tau ua raws, lossis cov nqi uas tsis tau mus rau lub rooj ntawm Tus Thawj Kav Tebchaws.​​  

DHCS Awards $150 lab los pab txhawb kev puas hlwb rau cov hluas thiab cov hluas​​  

Thaum Lub Kaum Ob Hlis 21, DHCS tau muab $ 150 lab rau 262 lub koom haum los txhawb kev noj qab haus huv thiab tsim kom muaj kev ywj pheej ntawm cov menyuam yaus, cov hluas, thiab cov tub ntxhais hluas.​​  

Cov khoom plig, tau txais nyiaj los ntawm CYBHI Evidence-based Practices (EBP) thiab Community-defined Evidence Practices (CDEP) Grant Program, tsom mus rau kev ncaj ncees thiab kev tsom mus rau cov tub ntxhais hluas thiab cov tub ntxhais hluas lub suab, lub zog, kev xav tau, qhov tseem ceeb, thiab kev paub dhau los, tshwj xeeb tshaj yog rau cov neeg uas muaj kev pheej hmoo tshaj plaws. Lawv kuj tseem tsav kev hloov pauv ntawm cov txheej txheem thiab siv kev kawm tas mus li ua lub hauv paus rau kev hloov pauv thiab kev txhim kho cov txiaj ntsig rau cov menyuam yaus thiab cov hluas. DHCS tau tshaj tawm cov npe tag nrho ntawm cov neeg tau txais nyiaj pab rau Qhov Thib Ob: Cov Kev Pabcuam thiab Kev Xyaum Ua Rau Muaj Kev Raug Mob thiab Qhov Thib Plaub: Cov Kev Pabcuam Uas Tsav Los Ntawm Cov Hluas.​​    

Lub Ib Hlis 2024 Medi-Cal MCP Kev Hloov Pauv​​ 

Raws li ib feem ntawm kev hloov pauv Medi-Cal, qee cov MCPs yuav hloov pauv rau lub Ib Hlis 1, 2024, thiab kwv yees li 1.2 lab tus tswv cuab yuav muaj cov kev xaiv phiaj xwm kho mob tshiab thiab/lossis yuav tsum hloov mus rau MCPs tshiab. Kev hloov MCPs yuav tsis cuam tshuam rau kev pab them nqi lossis cov txiaj ntsig ntawm Medi-Cal rau cov tswv cuab. Cov tswv cuab uas hloov mus rau MCP tshiab tau txais cov ntawv ceeb toom txog kev hloov pauv. DHCS tau tsim ntau yam kev pab los txhawb cov tswv cuab, cov neeg muab kev pab, thiab lwm cov neeg koom nrog kev hloov pauv, suav nrog nplooj ntawv web Managed Care Plan Transition Member nrog lub cuab yeej "nrhiav" hauv nroog, cov kev sib txuas rau cov ntawv ceeb toom rau cov tswv cuab xa los ntawm Medi-Cal txog kev hloov pauv MCP, cov lus nug nquag nug, thiab nplooj ntawv Tiv Tauj Peb rau cov tswv cuab kom paub ntau ntxiv txog cov phiaj xwm kev noj qab haus huv thiab cov kev xaiv ntawm cov neeg muab kev pab. Kuj tseem muaj cov peev txheej hloov pauv rau cov neeg muab kev pabcuam thiab MCPs thiab cov neeg koom nrog. Xav paub ntxiv txog kev hloov pauv no muaj nyob rau hauv Phau Ntawv Qhia Txog Txoj Cai Hloov Pauv ntawm Txoj Kev Npaj Saib Xyuas Kev Kho Mob Xyoo 2024 thiab Tsab Ntawv Qhia Txog Kev Tsim Nyog ntawm Medi-Cal Tus lej I 23-54.​​