DHCS Stakeholder News – December 23, 2022
DHCS tab tom muab qhov hloov tshiab ntawm kev txhim kho tseem ceeb ntawm DHCS cov kev pab cuam.
Xov xwm tshaj plaws
Txhim Kho Kev Tswj Xyuas Kev Kho Mob (ECM) thiab Zej Zog Txhawb Cov Ntaub Ntawv Ua Ntej Thaum Ntxov
On December 22, DHCS released early implementation data for ECM and Community Supports, two major CalAIM programs that launched in 2022. ECM and Community Supports were designed to support high-need Medi-Cal members and address social drivers that impact their health, such as housing and nutrition. Data show the early reach of ECM and Community Supports in January through June, and highlight growing member enrollment in both programs, particularly among historically underserved populations.
As California continues to strengthen its capacity to deliver ECM and Community Supports services, more members will benefit from the state’s efforts to transform Medi-Cal, expand how and where members receive care, and build an equitable health care system for all. DHCS is committed to transparency and will continue to release implementation data to showcase the growing impact of ECM and Community Supports on the Medi-Cal delivery system and members statewide.
Daim Ntawv Qhia Txog Tus Kws Kho Mob Tshiab rau Medi-Cal Managed Care Enrollment
DHCS tau tshaj tawm daim ntawv qhia txog qhov tseeb tshiab rau cov kws kho mob Medicare los piav qhia txog cov txheej txheem them nqi rau cov neeg muab kev pab rau ob tus tswv cuab uas tsim nyog tau sau npe rau hauv Medi-Cal managed care. Daim ntawv qhia no piav qhia txog cov txheej txheem them nqi hla kev uas twb muaj lawm, uas tsis hloov pauv hauv CalAIM. Cov kws kho mob Medicare uas pab cov neeg mob uas tsim nyog ob leeg tsis tas yuav sau npe rau hauv Medi-Cal managed care plan (MCP) kom txuas ntxiv tau txais nyiaj rov qab. Ntau tshaj 70 feem pua ntawm cov tswv cuab uas tsim nyog tau txais kev pab ob npaug thoob plaws lub xeev twb tau rau npe rau hauv Medi-Cal MCPs lawm. Cov txiaj ntsig Medicare thiab cov chaw muab kev pab tsis hloov pauv thaum koj rau npe rau hauv Medi-Cal MCP.
For patients in Original (fee-for-service (FFS)) Medicare, the Medicare Administrative Contractor processes the primary claim for Medicare payment, and then forwards the claim to the Medi-Cal MCP (or DHCS) for secondary Medi-Cal payment. For patients in Medicare Advantage (MA), the Medicare provider bills the MA plan for primary payment. The secondary payment process may depend upon whether the patient’s Medi-Cal MCP is the same or different than the MA plan. For more information, please visit the Statewide Medi-Cal Managed Care Enrollment for Dual Eligible Members webpage.
Public Charge All County Welfare Directors Letter luam tawm
On December 22, DHCS released All County Welfare Directors Letter (ACWDL) 22-34 to inform counties of the final rule, entitled “Public Charge Ground of Inadmissibility” (2022 Final Rule), published by the U.S. Department of Homeland Security on September 9, 2022. Effective December 23, the 2022 Final Rule restores previous policies, including the exclusion of Medicaid when determining the use of public benefits, with the exception of long-term institutionalized care, and will apply to applications for visas, admission, and adjustment of status postmarked on or after the effective date. The ACWDL reminds counties that the 2022 Final Rule does not change whether individuals can apply for and receive public benefits. The public charge status of a Medi-Cal applicant or member has no impact on their eligibility for Medi-Cal benefits.
Thaum lub Cuaj Hlis, tau muab ib daim ntawv qhia txog kev them nqi rau pej xeem (Public Charge Guide ) uas tau hloov kho tshiab (ua 21 hom lus) tso rau hauv lub vev xaib California Health & Human Services Agency los ua ib qho chaw rau cov tib neeg thiab cov tsev neeg uas muaj lus nug txog txoj cai them nqi rau pej xeem tam sim no. Koj tuaj yeem mus saib lub vev xaib US Citizenship & Immigration Services kom tau cov ntaub ntawv tshiab thiab cov peev txheej. Yog xav paub ntxiv txog txoj cai kawg thiab kev them nyiaj rau pej xeem, daim ntawv teev cov koom haum tsis nrhiav kev pab uas tsim nyog los pab cov tib neeg muaj nyob rau hauv lub vev xaib California Department of Social Services.
Kev hloov kho tshiab
Medi-Cal Rx
Cov ntawv ceeb toom hauv qab no rau Medi-Cal Rx rov qab los tau tshaj tawm thaum Lub Kaum Ob Hlis 20:
- 30-hnub ceeb toom rau Phase 2, Wave 1
- Hloov kho Medi-Cal tau pom zoo rau National Drug Code npe txheeb xyuas cov tshuaj cuam tshuam los ntawm Theem 2, Wave 1 ua ntej kev tso cai rov qab
- Theem 2 Cov Lus Nug Nquag (FAQ)
- 90-hnub ceeb toom rau Theem 3.
Cov ntaub ntawv xov xwm ntxiv txog cov phiaj xwm rov qab muaj nyob rau ntawm Medi-Cal Rx rov ua dua lub vev xaib.
Kev Pab Txhawb Kev Mloog Lus rau Cov Me Nyuam (HACCP) Kev Tsim Nyog Kev Tsim Nyog
Txij li thaum Lub Ib Hlis 1, DHCS txais tos cov tub ntxhais hluas uas tsim nyog tshiab hnub nyoog 18 txog 20 xyoo, uas ua tau raws li lwm cov qauv ntawm qhov kev pab cuam thiab xav tau kev pab them nqi rau lawv cov khoom siv pab hnov lus thiab cov kev pabcuam cuam tshuam, los thov rau kev sau npe HACCP. Tsis tas li ntawd xwb, txij li lub Ib Hlis tim 1, cov neeg thov uas muaj hnub nyoog qis dua 21 xyoo uas ua tau raws li cov cai tsim nyog ntawm txoj kev pab cuam yuav thov tau rau npe rau hauv HACCP txawm tias lawv muaj ib feem ntawm lwm yam kev pov hwm kho mob rau cov khoom siv pab hnov lus, raws li qhov txwv ntawm $ 1,500 lossis tsawg dua ib xyoos. Cov ntaub ntawv ntxiv txog qhov kev pab cuam muaj nyob rau ntawm nplooj ntawv web HACCP. Cov tsev neeg tuaj yeem thov rau kev them nqi los ntawm HACCP's Online Application Portal.
Phau Ntawv Qhia Rau Cov Kev Pabcuam Doula luam tawm
DHCS tau tshaj tawm phau ntawv muab kev pabcuam tshiab rau cov kev pabcuam doula thaum Lub Kaum Ob Hlis 16 ua ntej ntawm cov txiaj ntsig yuav nyob rau lub Ib Hlis 1, 2023. Phau ntawv piav qhia txog txoj cai rau FFS thiab cov kev tswj xyuas kev noj qab haus huv uas tau tsim los ntawm kev koom tes nrog cov neeg muaj feem cuam tshuam tom qab ntau tshaj li ib xyoos ntawm kev ua haujlwm ua ke. Lub Xeev Txoj Kev Hloov Kho 22-0002 rau cov kev pabcuam doula yog tam sim no tseem tos saib xyuas nrog Lub Chaw rau Medicare & Medicaid Services. Cov txiaj ntsig no yuav pab DHCS mus txog cov neeg muaj kev phom sij los tiv thaiv kev mob perinatal thiab txhim kho kev yug menyuam. Cov kev pabcuam Doula suav nrog kev kawm txog kev noj qab haus huv, kev tawm tswv yim, thiab kev txhawb nqa lub cev, kev xav, thiab tsis muaj kev kho mob muab thoob plaws lub sijhawm perinatal. Yog xav paub ntxiv, thov mus saib Doula Services raws li Medi-Cal Benefit lub vev xaib.
Los sai sai no: Medi-Cal Telehealth Updates
Thaum pib Lub Ib Hlis Ntuj xyoo 2023, DHCS yuav rov ua dua nplooj ntawv web telehealth kom suav nrog: Daim Ntawv Txoj Cai Telehealth tshiab uas qhia txog cov cai telehealth kawg raws li tau txais los ntawm kev siv nyiaj xyoo 2022-23 thiab cov kev hloov pauv ntawm txoj cai lij choj; Txoj Kev Tshawb Fawb thiab Kev Ntsuam Xyuas Telehealth; nplooj ntawv FAQ tshiab; kev hloov kho rau Phau Ntawv Qhia Txog Tus Muab Kev Pabcuam Medi-Cal Telehealth; thiab nplooj ntawv tshiab txog kev pom zoo ntawm tus neeg mob, suav nrog cov qauv lus rau cov kws kho mob.
Current telehealth flexibilities adopted under the federal COVID-19 public health emergency (PHE) will remain as long as the PHE is in effect, and most flexibilities in place during the PHE will continue after the expiration of the PHE. During the PHE, providers should consult the Telehealth Provider Manual and additional PHE guidance to direct their delivery of services. After the PHE ends, providers should consult strictly only the Medi-Cal Telehealth Provider Manual. For questions, email Medi-Cal_Telehealth@dhcs.ca.gov.
Clinic Workforce Stabilization Retention Payments (CWSRP) Daim ntawv thov
On December 29, DHCS will begin accepting applications for CWSRP. All qualified clinics that successfully registered by the registration deadline, December 28, will receive a link to the application and can begin submitting the required information on behalf of eligible employees.
All applications for payment must be submitted no later than 5 p.m. on January 27, 2023. DHCS encourages early submissions so all applications can be validated before the due date. DHCS anticipates issuing payments to qualified clinics in February 2023. Clinics receiving funding must issue payments to qualified employees within 60 days of receipt of funds.
Yuav muaj ib daim vis dis aus qhia txog kev thov daim ntawv thov, cov lus qhia txog kev thov, thiab ib daim qauv Excel rau kev xa cov ntaub ntawv ntawm cov neeg ua haujlwm rau ntawm nplooj ntawv web CWSRP thaum Lub Kaum Ob Hlis 29.
CalHOPE Courage Award Winners
Thaum Lub Ib Hlis 4, 2023, DHCS yuav lees paub lub Kaum Ob Hlis Ntuj CalHOPE Courage Award yeej ntawm Sacramento Kings NBA kev ua si ntawm Golden 1 Center. Cov khoom plig txhua hli qhuas cov tub ntxhais kawm-cov kis las hauv California cov tsev kawm qib siab thiab tsev kawm qib siab kom kov yeej cov kev ntxhov siab, kev ntxhov siab, thiab kev puas siab puas ntsws cuam tshuam nrog kev nyuaj siab ntawm tus kheej thiab kev txom nyem.
Koom nrog peb pab neeg
DHCS tab tom nrhiav neeg ua haujlwm! Peb tab tom nrhiav ib tus thawj coj uas muaj lub hom phiaj thiab mob siab rau ua tus Thawj Coj ntawm Pawg Neeg Saib Xyuas Tib Neeg. Peb kuj tseem tab tom ntiav ib tus Kws Pab Tswv Yim Txoj Cai rau Cov Neeg Tsis Muaj Tsev Nyob thiab Vaj Tse nyob rau hauv qhov kev pab cuam Kev Pabcuam Kev Noj Qab Haus Huv. Tus Kws Pab Tswv Yim Txoj Cai yog tus coj thiab sib koom tes npaj, tsim kho, thiab siv cov cai tshiab txog kev tsis muaj tsev nyob thiab vaj tse ntawm DHCS cov kev pab cuam.
Tsis tas li ntawd xwb, DHCS tab tom ntiav cov neeg California los koom nrog peb cov pab pawg nyiaj txiag, cov peev txheej tib neeg, kev cai lij choj, kev tshuaj xyuas, txoj cai kev noj qab haus huv, thiab cov ntaub ntawv thev naus laus zis. Yog xav paub ntxiv, thov mus saib lub vev xaib CalCareers.
DHCS mob siab rau kev tiv thaiv thiab txhim kho kev noj qab haus huv thiab kev nyob zoo ntawm txhua tus neeg California. Lub hom phiaj ntawm DHCS yog muab kev pabcuam kho mob zoo, pheej yig, thiab zoo rau cov neeg California uas tsim nyog, thiab tam sim no nws tab tom hloov pauv qhov kev pabcuam Medi-Cal kom ntseeg tau tias nws muab kev pabcuam uas tsom mus rau kev ncaj ncees thiab tsom mus rau tus neeg uas cov neeg California xav tau kom lawv muaj lub neej noj qab haus huv thiab zoo siab dua.
Hauv Case Koj Tsis Tau Nws
DHCS los nqis peev ntau lab los daws cov hluas siv Opioid
Thaum Lub Kaum Ob Hlis 20, DHCS tau tshaj tawm xov xwm tshaj tawm tias muaj ze li ntawm $ 3.4 lab hauv cov nyiaj pab uas muaj los pab txhim kho kev saib xyuas neeg mob hauv thaj tsam ntawm kev siv tshuaj yeeb tshuaj, kev siv tshuaj opioid, thiab kev quav tshuaj. Cov koom haum tuaj yeem thov nyiaj pab txog li $70,000.
Lub Sijhawm Daim Ntawv Thov yuav kaw sai sai rau Tsev Kho Mob thiab Chaw Pabcuam Saib Xyuas Neeg Mob (SNF) COVID-19 Tus Neeg Ua Haujlwm Retention Payments (WRP)
Lub sijhawm thov rau Tsev Kho Mob thiab SNF COVID-19 WRP kaw thaum 5 teev tsaus ntuj rau lub Kaum Ob Hlis 30. DHCS txhawb kom cov Chaw Ua Haujlwm Them Nqi (CEs), Cov Chaw Ua Haujlwm Them Nqi (CSEs), Cov Chaw Ua Haujlwm Pab Pawg Kws Kho Mob (PGEs), thiab Cov Kws Kho Mob Ywj Pheej uas tau sau npe ua tiav kom xa daim ntawv thov ua ntej hnub kawg kom txhua daim ntawv thov tuaj yeem raug lees paub raws sijhawm.
Yog tias koj yog CE, CSE, PGE, lossis ib tug kws kho mob ywj pheej thiab koj tseem tsis tau sau npe, hnub no, Lub Kaum Ob Hlis 23, yog hnub kawg rau kev sau npe.
Rau kev sau npe thiab daim ntawv thov kev taw qhia, daim ntawv thov video qhia, thiab tag nrho lwm cov ntaub ntawv txhawb nqa, thov mus saib ntawm WRP lub vev xaib.