Nyob zoo cov neeg muaj feem xyuam,​​ 

Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS) tab tom muab qhov hloov tshiab no ntawm kev txhim kho tseem ceeb ntawm DHCS cov kev pabcuam.​​ 

Xov xwm tshaj plaws​​ 

DHCS Cov Teeb Meem Thov rau Tsoom Fwv Teb Chaws Cov Neeg Koom Tes rau Monkeypox Kev Qhia​​ 

On August 12, DHCS sent a letter to the Centers for Medicare & Medicaid Services (CMS) requesting immediate guidance for establishing a Medicare rate for the monkeypox vaccine administration.​​ 

In an effort to be responsive to our Medi-Cal beneficiaries and providers, California will submit a Disaster State Plan Amendment to seek federal approval to reimburse vaccine administration and applicable laboratory testing at 100 percent of the Medicare rate, once established. As part of this request, DHCS will seek federal approval to reimburse Federally Qualified Health Centers, and similarly situated clinics that are paid an all-inclusive rate, the vaccine administration fee for vaccine-only visits, consistent with how DHCS is reimbursing for COVID-19 vaccine-only visits. The requested federal approvals will also include reimbursement for vaccine administration performed by non-clinic providers.​​ 

Additionally, please see the Centers for Disease Control and Prevention’s Reducing Stigma in Monkeypox Communication and Community Engagement and the California Department of Public Health’s toolkit messaging for sharing broadly among your networks.​​ 

Medi-Cal Nyiaj Them Nqi Them Nqi Them Rov Qab​​ 

Senate Bill 184 (Omnibus Health Bill 2022) tso cai DHCS kom txo cov nqi them rau cov kev pab cuam Medi-Cal kom xoom. Pib txij Lub Xya Hli 1, 2022, cov tswv cuab rau npe hauv cov kev pab cuam hauv qab no tsis tas yuav them tus nqi them raws li qhov yuav tsum tau muaj rau kev tsim nyog:​​  

• Optional Targeted Low Income Children’s Program​​ 
• Medi-Cal Access Program​​ 
• Medi-Cal Access Infant Program​​ 
• County Children’s Health Initiative Program​​ 
• 250 feem pua Kev Pabcuam Ua Haujlwm Pabcuam​​ 

DHCS released policy guidance via All County Welfare Directors Letter #22-14 and Medi-Cal Eligibility Division Information Letter #I 22-25, and is seeking federal authority to implement this policy through SPA 22-0042 and SPA 22-0034, which are pending CMS approval. Furthermore, DHCS has begun the process of issuing refunds to Medi-Cal and Children’s Health Insurance Program (CHIP) beneficiaries who overpaid their premiums as of July 1.​​ 

U.S. Surgeon General’s Comments on the Children and Youth Behavioral Health Initiative (CYBHI)​​ 

In a recent SAGE Journals article, U.S. Surgeon General Dr. Vivek H. Murthy highlighted the work that is underway through the CYBHI. The article serves as a call to action for the nation, with a stark reminder of what’s at stake in ensuring that children and youth receive the help they need when and where they need it, especially those in our most underserved communities.​​ 

The CYBHI, which includes multiple work streams that are led by five departments and offices within the California Health & Human Services Agency (CalHHS) – DHCS, Department of Health Care Access and Information, Department of Managed Health Care, California Department of Public Health, and the Office of the California Surgeon General – focuses on promoting mental, emotional, and behavioral well-being by preventing challenges and providing services, support, and routine screening for all children and youth for emerging and existing needs.​​ 

Kev hloov kho tshiab​​ 

Medi-Cal Kev Tshaj Tawm thiab Kev Pab Cuam Npe rau Cov Neeg Laus California​​ 

DHCS tab tom muab kev nthuav qhia thiab kev tso npe nkag rau 28,000 tus neeg laus laus uas muaj peev xwm tsim nyog tau txais kev pab them nqi kho mob Medi-Cal. DHCS tau muab $24 lab rau California State Association of Counties thiab California Coverage & Health Initiatives (CCHI) los koom tes rau kev pab rau kev sau npe mus txog rau lub Rau Hli 30, 2024. Kev siv zog yog tsom rau:​​ 

• Ob tus neeg tau txais txiaj ntsig los yog cov neeg tau txais txiaj ntsig muaj hnub nyoog 65 xyoo thiab laus dua nrog rau kev txiav txim siab txog kev tsim nyog Medi-Cal uas tseem tshuav.​​ 
• Cov neeg muaj hnub nyoog 65 xyoos thiab laus dua uas twb tau cuv npe hauv Medi-Cal thiab xav tau kev pab los txiav txim qhov tsim nyog ntawm Medicare.​​  
• Cov tib neeg muaj hnub nyoog 65 xyoos thiab laus dua lossis muaj kev xiam oob qhab uas tsim nyog tau txais Medi-Cal, tab sis tam sim no tsis tau cuv npe, suav nrog cov uas tsim nyog rau Medicare Savings Programs.​​ 
• Cov tib neeg tshiab tsim nyog tau txais Medi-Cal vim Medi-Cal nthuav dav rau cov neeg laus hnub nyoog 50 xyoo thiab laus dua, tsis hais txog kev nkag tebchaws.​​ 
• Cov neeg tau txais txiaj ntsig Medi-Cal uas muaj hnub nyoog 65 xyoos tseem tsis tau tso npe rau hauv Medicare, ua raws li kev pom zoo nrog ib lossis ntau dua Medi-Cal cov kev pab them nqi kho mob (MCP) hauv lub nroog ntawd.​​ 

CCHI yuav tau txais kev pab los ntawm cov koom haum hauv zej zog uas muaj ntau xyoo dhau los ua kev nthuav qhia thiab kev pab rau npe rau cov neeg tau txais txiaj ntsig Medi-Cal kom ntseeg tau tias cov neeg tsim nyog tau txais Medi-Cal muaj kev nkag tau mus rau cov kev pab kho mob ntau ntxiv los txhim kho cov txiaj ntsig thiab txo qis kev noj qab haus huv. Yog xav paub ntxiv, thov mus saib hauv Medi-Cal Kev Tshaj Tawm thiab Kev Sau Npe rau Cov Neeg Laus California lub vev xaib.​​ 

CHIP Kev Sau Npe thiab Kev Txiav Txim Dua Txoj Cai Hloov Tshiab​​ 

On August 3, CMS approved DHCS’ State Plan Amendment (SPA) CA-22-0035 submission, allowing DHCS to implement provisions for temporary adjustments to enrollment and redetermination policies. Effective July 1, 2022, DHCS is able to use a regulatory timeliness exception for the timely processing of CHIP applications and renewals for children in families living and/or working in state- or federally-declared disaster areas.​​ 

Los ntawm qhov SPA no, California tab tom hloov kho cov txheej txheem los ua kom nws cov kev pab cuam daws kev puas tsuaj tau pom zoo los ntawm SPA CA-17-0043 nrog cov qauv tshiab SPA kev pab cuam kev puas tsuaj uas tau tshaj tawm thaum Lub Peb Hlis 2022. Cov kev cai SPA no tuaj yeem siv tau rau yav tom ntej lub xeev- lossis tseem ceeb tshaj tawm kev puas tsuaj los ntawm kev ceeb toom rau CMS ntawm cov hnub siv tau ntawm cov kev cai thiab thaj chaw cuam tshuam los ntawm kev puas tsuaj.​​ 

Mobile Crisis Services Request for Information (RFI) Tso tawm​​ 

On August 8, DHCS released a RFI for the mobile crisis services benefit. The RFI invites vendors to provide DHCS with information to support training for and implementation of mobile crisis services. DHCS intends to submit a SPA to add qualifying community-based mobile crisis intervention services as a new Medi-Cal benefit, effective no sooner than January 2023. Implementing mobile crisis services is an integral part of California’s broader efforts to strengthen the continuum of community-based care for Medi-Cal beneficiaries who are experiencing a mental health or substance use disorder crisis.​​ 

DHCS tab tom txhim kho Medi-Cal cov kev pab cuam mobile daws teeb meem, uas yuav suav nrog cov ntaub ntawv thiab cov lus qhia ntsig txog kev cob qhia, kev tshuaj xyuas kev npaj, thiab kev pab cuam.​​ 

Tsev Kho Mob thiab Kws Kho Mob Kws Kho Mob COVID-19 Kev Pabcuam Cov Neeg Ua Haujlwm Retention Payments​​ 

DHCS tab tom muab cov lus qhia tshiab txog hnub sau tseg thiab hnub kawg ntawm kev xa mus rau qhov kev pab cuam no:​​ 

• Txog hnub tim sau tseg, cov neeg ua haujlwm tsim nyog yuav tsum tau ua haujlwm los ntawm ib lub chaw them nyiaj lossis cov chaw ua haujlwm them nyiaj ntawm lub chaw tsim nyog ua ntej lub Kaum Ib Hlis 28, 2022, thiaj li tsim nyog tau txais cov nyiaj tuav pov hwm.​​ 
• Txog hnub kawg ntawm kev xa ntawv, cov koom haum thiab cov chaw ua haujlwm them nyiaj yuav tsum xa lawv daim ntawv thov, suav nrog cov npe ntawm cov neeg ua haujlwm tsim nyog, tsis pub dhau 5 teev tsaus ntuj rau lub Kaum Ob Hlis 30, 2022.​​ 

Nyob rau lub asthiv tom ntej no, DHCS yuav muab cov lus qhia ntxiv txog cov txheej txheem xa ntawv thiab cov kev hloov tshiab dav dav los ntawm cov lus tshaj tawm txhua lub limtiam ntawm cov neeg muaj feem cuam tshuam thiab hauv Tsev Kho Mob thiab Chaw Pabcuam Kws Kho Mob COVID-19 Cov Neeg Ua Haujlwm Tuav Nyiaj Them Nyiaj hauv lub vev xaib.​​ 

Kev Pab Txhawb Kev Mloog Lus Rau Cov Me Nyuam (HACCP) Hloov tshiab​​ 

DHCS nthuav dav cov txiaj ntsig tau txais txiaj ntsig rau txoj cai A1 kom suav nrog HACCP cov txiaj ntsig tshiab ntsig txog cov pob txha pob txha pob qij txha (BCHDs), siv tau rov qab rau cov hnub ua haujlwm rau lossis tom qab Lub Xya Hli 1, 2021.​​ 

For more information about HACCP coverage of BCHDs, please see the Medi-Cal Provider Newsflash. For information about the program more broadly, please see DHCS’ HACCP webpage, which was recently expanded to include additional resources for families and providers, including a secure chat option for communicating with the HACCP Call Center or uploading additional materials for an application that has already been submitted. Additionally, families seeking to apply for HACCP coverage may now submit their application electronically through the HACCP Online Application Portal.​​ 

Medi-Cal Rx Kev Hloov Kho Kev Ua Haujlwm​​ 

DHCS thiab Magellan (MMA) koom nrog cov txheej txheem kev npaj ua haujlwm hnyav rau cov txheej txheem rov ua dua tshiab ntawm kev thov hloov kho thiab kev tso cai ua ntej (PA) cov cai.​​ 

• Theem ib, nthwv dej ib, tau muab coj los siv rau lub Xya Hli 22, 2022, txhawm rau rov ua cov ntaub ntawv hloov kho rau National Council for Prescription Drug Programs (NCPDP) Reject Code 88 – Drug Utilization Review (DUR) Reject Error for DUR alerts, such as drug-drug interactions, high dose, early refill, etc. Txoj kev rov ua dua tshiab yog maj mam thiab rov ua dua, nrog rau kev mob siab rau cov neeg koom nrog kev npaj thiab kev saib xyuas kev ua haujlwm. Nws yuav raug kho kom zoo raws li qhov tsim nyog nyob rau lub sijhawm raws li kev txheeb xyuas cov ntaub ntawv, kev paub txog kev ua haujlwm, thiab cov lus tawm tswv yim ntawm cov neeg koom nrog.​​ 
• Theem ib, nthwv dej ob, tam sim no muaj txiaj ntsig, tsom mus rau kev txhawb nqa kev siv CoverMyMeds (CMM).​​ 
• Phase one, wave three is slated to begin on September 16 with the reinstatement of PA requirements for 11 drug classes for new start prescriptions for beneficiaries 22 years of age and older. Stakeholders are encouraged to continue submitting comments and feedback on the reinstatement approach via Reinstatement@dhcs.ca.gov.​​  

Community Health Workers (CHW) SPA pom zoo​​ 

On July 26, DHCS received CMS approval for SPA 22-0001, which adds CHW as a preventive service. Developed in consultation with stakeholders, this SPA created CHW services as a Medi-Cal benefit, effective July 1, 2022, for both fee-for-service and managed care delivery systems. For more information about CHW services, including a link to the provider manual, please see the CHW webpage.​​ 

Tshaj tawm cov ntaub ntawv COVID-19​​ 

• Daim Ntawv Qhia Ntxiv K rau 1915(c) Daim Ntawv Pom Zoo Tso Cai: HCBS Cov Kev Pab Txhawb Tus Kheej​​  
• Daim Ntawv Ntxiv K rau 1915(c) Kev Zam: HCBS Cov Kev Pab Txhawb Tus Kheej​​  

Cov Rooj Sib Tham Cov Neeg Koom Tes thiab Webinar yuav los tom ntej​​ 

California Advancing and Innovating Medi-Cal (CalAIM) Waiver Renewals Webinar​​ 

On August 22 at 10 a.m., DHCS will virtually host a public hearing to receive stakeholder feedback on the proposed amendments to the CalAIM Section 1115 demonstration and Section 1915(b) waiver. Please register for this webinar in advance.​​ 

DHCS launched 30-day public comment and Tribal public comment periods on August 12. DHCS is seeking the CalAIM Section 1115 and 1915(b) amendment approvals from CMS to implement county-based model changes in the Medi-Cal Managed Care (MCMC) program. Through the Section 1915(b) waiver amendment, DHCS also plans to add or update language on policies or programs in the approved CalAIM 1915(b) waiver, including to reflect the MCMC model changes in select counties and direct contracts with the Kaiser Foundation Health Plan available for enrollment of certain Medi-Cal beneficiary populations in select counties. Additional information about the CalAIM Section 1115 demonstration application and Section 1915(b) overview are available on the CalAIM 1115 Demonstration & 1915(b) Waiver webpage. The 30-day public comment and Tribal public comment periods end on September 12.​​ 

Tham nrog Family PACT Cov Neeg Siv Khoom Txog Kev Txhaj Tshuaj HPV​​ 

On August 17, DHCS and the California Prevention Training Center will hold a webinar to provide information about the effectiveness and safety of the human papillomavirus (HPV) vaccine, review current Centers for Disease Control and Prevention recommendations for the use of the HPV vaccine, and provide advice on how to have effective shared decision-making conversations with clients about being immunized. Advance registration for PACT webinar is required. Effective July 1, 2022, the Family PACT program added HPV vaccination as a clinic benefit for individuals ages 19 through 45. For those unable to attend the live webinar, a transcript and recording of the webinar, along with additional resources, will be available on the Family PACT website.​​ 

Medi-Cal Dental Statewide Stakeholder Meeting​​ 

Thaum Lub Yim Hli 18 thaum 10 teev sawv ntxov, DHCS yuav tuav lub rooj sib tham virtual Medi-Cal Dental Statewide Stakeholder. Lub hom phiaj ntawm lub rooj sib tham no yog muab cov neeg muaj feem cuam tshuam txog kev kho hniav thoob plaws hauv lub xeev lub rooj sab laj los qhia tawm tswv yim txog Medi-Cal Dental program, thiab rau DHCS los qhia cov kev hloov tshiab thiab cov ntaub ntawv tseem ceeb ntawm cov tshiab thiab/los yog kev siv zog ua haujlwm yav tom ntej. Cov ntaub ntawv ntxiv muaj nyob rau ntawm Medi-Cal Dental Statewide Stakeholder lub rooj sib tham lub vev xaib.​​ 

DHCS CalAIM MLTSS thiab Duals Integration Workgroup Meeting​​ 

On August 18 at 10 a.m., DHCS will virtually host the CalAIM Managed Long-Term Services and Supports (MLTSS) and Duals Integration Workgroup meeting. Please register for the meeting, which is open to the public.​​ 

The meeting will serve as a stakeholder collaboration hub for CalAIM MLTSS and integrated care for dual eligible beneficiaries. It will also give stakeholders an opportunity to provide feedback and share information about policy, operations, and strategy for upcoming changes to Medicare and Medi-Cal. Agenda items include a summary of January 2023 enrollment changes; a presentation on the January 2023 transitions impacting dual eligible beneficiaries, including noticing, monitoring, and timelines; and an update on the Dementia Care Aware initiative.​​ 

Background materials, transcripts, and video recordings of the previous workgroup meetings, along with additional information about the workgroup, are posted on the CalAIM MLTSS and Duals Integration Workgroup webpage.​​ 

Smile, California Kev Sib Tw rau Medi-Cal Dental Services​​ 

Smile, California is hosting Facebook Live presentations for Medi-Cal members in Spanish and English. The Spanish presentation will be held on August 24 at 1 p.m.; RSVP on Facebook. The English presentation will be held on August 26 at 1 p.m.; RSVP on Facebook. A Smile, California member outreach representative will deliver the Smile, your Medi-Cal benefits include dental! presentation, and a provider relations trainer will assist with answering audience questions.​​ 

PAVE Portal Kev cob qhia rau cov kws kho hniav​​ 

On August 24 at 11 a.m., DHCS will host a webinar introduction to PAVE for dental providers. Beginning on October 31, DHCS will implement the PAVE portal for dental providers, offering a new mode for submitting dental provider enrollment applications and required documentation to DHCS. This allows applicants to use the Medi-Cal Provider e-Form Application, as DHCS will no longer accept paper applications once PAVE is implemented. For more information about the webinar, including the registration link for the August 24 training, please view this Medi-Cal Dental Provider Bulletin. The PAVE demonstrations will be recorded and posted on the DHCS PAVE webpage.​​  

DHCS Lub Rooj Sib Tham ntawm Family Planning Stakeholder Meeting​​   

On August 24, DHCS will host a virtual family planning stakeholder meeting. The link to the meeting will be available on the Office of Family Planning webpage prior to the meeting.​​ 

Lub Rooj Sib Tham Doula Benefit Stakeholder​​ 

On August 24, DHCS will host a virtual stakeholder workgroup meeting about adding doula services as a covered Medi-Cal benefit. The meeting is open to the public. DHCS will engage with workgroup members on policy development details that will be reflected in the Medi-Cal provider manual and other policy guidance documents. All interested stakeholders may listen to the workgroup discussion regarding stakeholder feedback and provide input via email. DHCS will also share an update on the status of formal submission of the SPA to CMS. The link for the stakeholder meeting will be available on the doula webpage prior to the meeting.​​ 

CalAIM Webinar: Txhim Kho Kev Tswj Xyuas (ECM) thiab Zej Zog Txhawb Kev Koom Tes rau Cov Tswv Cuab​​ 

On August 25 at 1:30 p.m., DHCS will host an all-comers webinar on CalAIM ECM and Community Supports member engagement. Topics for this session will include provider and member communications, referrals, outreach, and enrollment. This event is part of a series of technical assistance and informational sessions focused on supporting implementation of ECM and Community Supports. Throughout the series, DHCS leaders will be joined by presenters from MCPs, providers, and CBOs implementing CalAIM.​​ 

Advance registration for CalAIM webinar is required. Participants are invited to submit questions by August 22 to CalAIMECMILOS@dhcs.ca.gov. Attendees will also have the opportunity to ask questions during the webinar. An additional “Office Hours” event will be held on September 1 at 2 p.m. (see below) for attendees to ask any other questions not covered during the webinar.​​ 

CYBHI Lub Hlis Webinar​​ 

On August 29 at 3 p.m., DHCS will virtually host a webinar to keep stakeholders apprised of DHCS’ progress in implementing various work streams of the CYBHI. Key attendees include, but are not limited to, youth, parents, family members, behavioral health providers, Medi-Cal MCPs, county behavioral health departments, and commercial health plans, as well as education and other cross-sector partners. CYBHI Monthly Webinar advance registration is required.​​ 

CalAIM Lub Sijhawm Ua Haujlwm: ECM thiab Zej Zog Txhawb Kev Koom Tes rau Cov Tswvcuab​​ 

On September 1 at 2 p.m., DHCS will virtually host an “Office Hours” discussion on CalAIM ECM and Community Supports member engagement. As a follow-up to the August 25 webinar on this topic, this question and answer session will cover provider and member communications, referrals, outreach, and enrollment. This event is part of a series of “Office Hours” events focused on answering implementation questions from the field.​​ 

Advance registration is required. Participants are invited to submit questions by August 29 to CalAIMECMILOS@dhcs.ca.gov. Attendees will also have an opportunity to ask questions during the session.​​