DHCS Stakeholder News – August 26, 2022
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
Medi-Cal Managed Care Procurement Update
Thaum Lub Yim Hli 25, DHCS tau tshaj tawm Daim Ntawv Ceeb Toom Txog Kev Xav Tau Txais (NOIAs) rau Medi-Cal cov phiaj xwm tswj hwm kev saib xyuas (MCP) cog lus los muab kev pabcuam rau cov tswvcuab pib thaum Lub Ib Hlis 1, 2024. DHCS npaj siab muab 28 daim ntawv cog lus rau MCPs hauv qab no kom xa cov kev pabcuam Medi-Cal hauv 21 lub nroog, raws li teev hauv qab no:
| Xav tau cov puav pheej | Lub nroog |
| Molina Health Care | Los Angeles, Riverside, San Bernardino, Sacramento, San Diego |
| Anthem Blue Cross Partnership Plan | Alpine, Amador, Calaveras, El Dorado, Fresno, Inyo, Kern, Vaj, Madera, Mono, Santa Clara, San Francisco, Sacramento, Tuolumne |
| Health Net | Amador, Calaveras, Inyo, Mono, San Diego, San Joaquin, Stanislaus, Tulare, Tuolumne |
Lub xeev tab tom nce kev cia siab ntawm cov phiaj xwm hauv Medi-Cal qhov kev pab cuam. Daim ntawv cog lus kho dua tshiab thiab muaj kev tswj xyuas zoo dua yuav tuav MCP cov neeg koom tes thiab lawv cov neeg ua haujlwm ua haujlwm ua haujlwm ntau dua rau:
- Kev saib xyuas zoo, siv tau, thiab kev saib xyuas thoob plaws txhua qhov chaw thiab theem kev saib xyuas,
- Txo kev noj qab haus huv tsis sib xws,
- Txhim kho cov txiaj ntsig kev noj qab haus huv, thiab
- Transparency los ntawm kev ua kom muaj cov ntaub ntawv thiab kev nkag siab los txhawb kev xaiv txoj kev npaj.
Txawm hais tias qhov kev yuav khoom tsuas yog siv rau cov MCPs lag luam xwb, cov ntawv cog lus tshiab yuav siv rau txhua tus MCPs, suav nrog Lub Nroog Cov Txheej Txheem Kev Noj Qab Haus Huv, Cov Kev Pib Hauv Zos, Tus Qauv Kev Npaj Ib Leeg Tshiab, thiab Kaiser, pib xyoo 2024. Yog xav paub ntxiv txog kev yuav khoom thiab daim ntawv cog lus ntawm MCP, thov mus saib lub vev xaib DHCS.
County COVID-19 Public Health Emergency (PHE) Unwinding Readiness Toolkit
Thaum Lub Yim Hli 26, DHCS tau tshaj tawm cov cuab yeej npaj txhij rau kev daws teeb meem COVID-19 PHE hauv nroog thiab Tsab Ntawv Qhia Txog Kev Tsim Nyog Medi-Cal rau cov nroog. Cov nroog raug txhawb kom siv daim ntawv teev cov kev npaj txhij ntawm lub nroog thiab cov tswv yim pom zoo los npaj rau cov haujlwm COVID-19 PHE thiab rov pib ua haujlwm Medi-Cal ib txwm. Cov nroog yuav tsum siv daim ntawv qauv npaj txhij rau COVID-19 PHE ntawm lub nroog los sau lawv txoj kev npaj ua haujlwm PHE, uas cov nroog yuav tsum xa mus rau DHCS tsis pub dhau 10 hnub ua ntej PHE xaus. DHCS yuav nthuav qhia cov cuab yeej rau cov nroog thaum lub Cuaj Hli ua ib feem ntawm cov rooj sib tham txhua hli ntawm kev koom tes ntawm lub nroog.
Kev hloov kho tshiab
PATH Collaborative Planning and Implementation Initiative Registration Participant Registration
DHCS tab tom tsim cov pab pawg sib koom ua ke hauv cheeb tsam los pab txheeb xyuas thiab daws cov teeb meem kev siv CalAIM hauv zos thiab qhia seb cov peev txheej pib tuaj yeem pab txhawb kev nqis tes ua txhawm rau txhim kho cov pej xeem noj qab haus huv thaum kawg. Cov pab pawg no yuav suav nrog cov neeg sawv cev rau MCPs, cov kws kho mob, cov koom haum saib xyuas kev noj qab haus huv hauv zej zog, cov koom haum hauv nroog thiab nroog, cov tsev kho mob pej xeem, Medi-Cal Tribal thiab Cov Neeg Tsim Nyog ntawm Indian Health Programs, thiab lwm yam.
On August 22, DHCS launched a participant registration form for the Providing Access and Transforming Health (PATH) Collaborative Planning and Implementation initiative. Eligible entities can register now to participate in a collaborative planning group in their region. Please email collaborative@ca-path.com with any questions about the participant registration process.
Tsev Kho Mob thiab Chaw Kho Mob Kws Kho Mob COVID-19 Cov Neeg Ua Haujlwm Retention Them Nyiaj
DHCS tau tshaj tawm thawj cov lus nug nquag nug ntawm SNF (FAQs) thiab Cov Lus Txhais ntawm Cov Lus hauv nplooj ntawv web ntawm Tsev Kho Mob thiab Chaw Saib Xyuas Neeg Mob COVID-19 Cov Nyiaj Them Rov Qab Rau Cov Neeg Ua Haujlwm. Cov FAQs yuav raug hloov kho tsis tu ncua, thiab cov ntaub ntawv hais txog cov txheej txheem xa daim ntawv thov yuav raug tso tawm hauv ob peb lub lis piam tom ntej. Yog xav paub txog cov xov xwm tshiab thiab cov ntaub ntawv qhia txog qhov kev pab cuam, thov mus saib nplooj ntawv web no lossis xa cov lus nug mus rau wrp@dhcs.ca.gov.
Medi-Cal Rx Kev Hloov Kho Kev Ua Haujlwm
On August 16, DHCS published a bulletin announcing the next step of the Medi-Cal Rx Claim Edit and Prior Authorization (PA) Reinstatement effort. Beginning on September 16, PAs requirements will be reinstated for 11 drug classes for new start (first time) medications for beneficiaries 22 years of age and older. Additionally, DHCS determined that prescriptions for new start medications within the 11 drug classes for beneficiaries 21 years of age and under will be excluded from PA reinstatement. DHCS recognizes that providers of specialty pediatric services have been significantly impacted by the transition to Medi-Cal Rx, and exclusion of this population from this wave prevents additional administrative obligation by providers at this time.
Tsis tas li ntawd xwb, kev hloov kho tshiab txhua hli rau Daim Ntawv Teev Tshuaj Cog Lus yuav pib siv rau lub Cuaj Hlis 1, uas yuav tso cai rau Medi-Cal Rx los soj ntsuam qhov cuam tshuam ntawm cov nthwv dej yav dhau los thiab txheeb xyuas cov cib fim los txhim kho kev paub ntawm cov neeg muab kev pabcuam los ntawm kev sib txuas lus thiab kev sib koom tes. Yuav muaj ib daim ntawv tshaj tawm 15 hnub rau lub Cuaj Hlis 1, thiab cov neeg koom nrog raug txhawb kom txuas ntxiv xa cov lus tawm tswv yim thiab cov lus taw qhia txog kev rov qab kho PA mus rau Reinstatement@dhcs.ca.gov.
Tshaj tawm cov ntaub ntawv COVID-19
- MEDIL I 22-33: Lub Nroog Readiness Toolkit rau Kev Npaj Tus Kab Mob Coronavirus tshiab (COVID-19) Public Health Emergency (PHE) Unwinding thiab Resumption of normal Medi-Cal Operations
- MEDIL I 22-34: COVID-19 Pej Xeem Kev Noj Qab Haus Huv Emergency (PHE) Unwinding rau cov tib neeg uas muaj hnub nyoog tawm ntawm Cov Hluas Kev Loj Hlob Thaum PHE
Cov Rooj Sib Tham Cov Neeg Koom Tes thiab Webinar yuav los tom ntej
CYBHI Lub hli Public Webinar
Thaum Lub Yim Hli 29 thaum 3 teev tsaus ntuj, DHCS yuav tuav lub rooj sib tham hauv online rau pej xeem txog DHCS txoj kev nce qib hauv kev siv ntau yam haujlwm rau Children and Youth Behavioral Health Initiative (CYBHI). Cov neeg tuaj koom tseem ceeb suav nrog, tab sis tsis txwv rau, cov hluas, cov niam txiv, cov tswv cuab, cov kws kho mob kev coj cwj pwm, Medi-Cal MCPs, cov chaw haujlwm kev kho mob kev coj cwj pwm hauv nroog, thiab cov phiaj xwm kev noj qab haus huv lag luam, nrog rau kev kawm thiab lwm cov neeg koom tes thoob plaws. Yuav tsum tau sau npe ua ntej .
Lub Rooj Sib Tham Hearing Aid Coverage for Children Program (HACCP).
On August 31 at 3 p.m., DHCS will host a virtual ad hoc HACCP stakeholder meeting to share program updates and information on new and upcoming work efforts. Additional information is available via the Hearing Aid Coverage for Children Program webpage.
CalAIM Webinar: ECM Cov Neeg Saib Xyuas Lub Sij Hawm Ntev ntawm Kev Pom Zoo
On September 8 at 1:30 p.m., DHCS will host a webinar on CalAIM ECM Long-Term Care Populations of Focus. Advance registration is required. Participants are invited to submit questions by September 5 to CalAIMECMILOS@dhcs.ca.gov. Attendees will also have an opportunity to ask questions during the session.