Tsev Chav Xov Xwm - Chaw Ua Haujlwm Sib Txuas Lus Xov Xwm Txog Cov Neeg Muaj Feem Cuam Tshuam ntawm DHCS - Lub Ib Hlis 6, 2023​​ 

DHCS Stakeholder News – January 6, 2023​​ 

Xov xwm tshaj plaws​​ 

Tsib Txoj Kev Npaj Pabcuam Medi-Cal Cov Neeg Saib Xyuas Kev Tswj Xyuas Cov Tswvcuab raws li Daim Ntawv Pom Zoo​​ 

On December 30, DHCS and five commercial health plans – Blue Cross of California Partnership Plan (“Anthem”), Blue Shield of California Promise Health Plan, CHG Foundation d.b.a. Community Health Group Partnership Plan, Health Net Community Solutions, Inc. and Molina Healthcare of California – announced an agreement to deliver Medi-Cal services to Medi-Cal managed care members in 21 counties across the state starting in January 2024. RFP #20-10029 for the Medi-Cal MCPs was cancelled. 

The state’s top priority is to ensure that Medi-Cal members have access to managed care plans that provide high-quality and timely care and are focused on delivering on the State’s transformations that are designed to move the health system to become person-centered, equity-focused, and data-driven. To bring certainty for members, providers and plans, the state used its authority to work directly with the plans to re-chart our partnership and move with confidence and speed toward the implementation of the changes we want to see. As part of this agreement, Medi-Cal managed care plans will be held to new standards of care and greater accountability, helping ensure Medi-Cal members have the care and support they need to live healthier, more fulfilling lives.​​   

Daim ntawv thov Doula muab kev pabcuam tam sim no txais​​ 

Effective January 1, 2023, DHCS added doula services throughout pregnancy, childbirth, and postpartum period as a Medi-Cal benefit. Updates to the Provider Application and Validation for Enrollment (PAVE) portal have been completed, and doulas may now access PAVE and submit their Medi-Cal enrollment application.

DHCS has created a self-paced video demonstration, Introduction to PAVE for Doula Providers, specifically for doula providers who are accessing PAVE for the first time. On January 10 at 10 a.m., DHCS will also host a virtual live session (advance registration required) to demonstrate how to use the PAVE portal. In addition, DHCS created a webpage, Medi-Cal: Doulas – Training as Medi-Cal Providers, that hosts different trainings for doulas regarding Medi-Cal. Additional trainings will be added as they become available.​​ 

Cov Kev Pabcuam Tshiab thiab Txoj Haujlwm Pib Tshaj Tawm hauv 2023​​ 

Cov phiaj xwm Medi-Cal hauv qab no tau pib rau lub Ib Hlis 1, 2023, ntxiv rau qhov kev pab cuam Medi-Cal kom muaj kev sib koom ua ke, kev sib koom tes, thiab tib neeg nyob nruab nrab—thiab thaum kawg ua rau cov txiaj ntsig kev noj qab haus huv zoo dua rau cov tswv cuab Medi-Cal.​​  

  • CalAIM Population Health Management (PHM) Program: Medi-Cal managed care plans (MCPs) began implementing the PHM Program, a cornerstone of CalAIM. The PHM Program establishes a cohesive, statewide approach that ensures all Medi-Cal members have access to a comprehensive program that leads to longer and healthier lives, improved health outcomes, and health equity. The updated PHM Policy Guide and new Frequently Asked Questions (FAQs) are available on the DHCS CalAIM PHM webpage.​​ 
  • Kev hloov pauv ntawm Cal MediConnect (CMC) mus rau Medicare Medi-Cal (Medi-Medi) Cov Phiaj Xwm: Cov phiaj xwm Medi-Medi tau pib siv hauv xya lub nroog, thiab cov tswv cuab ntawm CMC tau hloov mus rau Medi-Medi Cov Phiaj Xwm hauv cov nroog ntawd. Cov phiaj xwm Medi-Medi muab kev saib xyuas dav dav rau cov tib neeg uas tsim nyog tau txais Medicare thiab Medi-Cal. DHCS kuj tau hloov qhov kev pab cuam Medi-Cal rau cov tswv cuab no mus rau Medi-Cal Rx. Cov phiaj xwm Medi-Medi yuav sib koom tes cov txiaj ntsig thiab cov kev pabcuam thoob plaws Medicare thiab Medi-Cal suav nrog kev them nqi tshuaj Part D. Medi-Cal Rx yuav rov ua haujlwm ua tus thawj coj saib xyuas cov txiaj ntsig ntawm Medi-Cal rau kev them nqi tshuaj uas tsis yog Medicare. Kev saib xyuas tom qab kev siv yuav txuas ntxiv mus rau ob peb lub lis piam.​​ 
  • Long-Term Care Carve-in to Medi-Cal Managed Care: Under CalAIM, Medi-Cal MCPs will cover and coordinate institutional Long-Term Care in all counties in 2023 in a phased approach by facility type. This will provide a LTC resident with access to coordinated and integrated care within Medi-Cal managed care and make coverage consistent across California. All MCPs are now responsible for the full LTC benefit at skilled nursing facilities, including both freestanding and hospital-based SNFs. The January 2023 transition does not apply to Intermediate Care Facilities for Developmentally Disabled or Subacute Facilities.​​    
  • Cov Txheej Txheem Thov Medi-Cal Ua Ntej Tso Tawm uas Muaj Kev Ncaj Ncees: Tam sim no txhua lub nroog yuav tsum tau siv Cov Txheej Txheem Thov Medi-Cal Ua Ntej Tso Tawm raws li tau teev tseg hauv Assembly Bill 133 (Tshooj 143, Cov Cai Lij Choj ntawm xyoo 2021) kom ntseeg tau tias txhua tus neeg raug kaw thiab cov hluas uas tsim nyog uas tau raug tso tawm ntawm cov chaw kaw neeg hauv nroog (cov tsev loj cuj hauv nroog) thiab cov chaw kaw neeg hluas hauv nroog muaj kev pab them nqi Medi-Cal thaum tso tawm. Cov ntaub ntawv ntxiv tuaj yeem pom nyob rau hauv Tsab Ntawv Qhia Txog Kev Noj Qab Haus Huv ntawm Txhua Lub Nroog (ACWDL) 22-27.
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  • Xeev Lub Xeev Medi-Cal Managed Care Enrollment for Dual Eligibles and Other Populations: Feem ntau cov tswv cuab uas tsim nyog tau txais kev pab feem ntau uas tsis tau tso npe rau hauv Medi-Cal tswj kev saib xyuas tam sim no yuav tau rau npe rau hauv Medi-Cal cov phiaj xwm. Medi-Cal cov kev pab them nqi kho mob thiab kev sib koom tes rau ob tus tswv cuab uas tsim nyog. Cov kws kho mob Medicare pab cov neeg mob ob leeg tsis tas yuav tso npe rau hauv Medi-Cal txoj kev npaj kom tau txais cov nyiaj them rov qab li qub. Ua ntej lub Ib Hlis 2023, ntau dua 70 feem pua ntawm cov tswv cuab ob leeg tau txais kev tso npe hauv Medi-Cal MCPs.  
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  • CalAIM Incentive Payment Program (IPP): Qhov IPP Program Xyoo 2 tau pib rau lub Ib Hlis 1. Txij lub Ib Hlis Ntuj xyoo 2022 mus txog rau lub Kaum Ob Hlis Ntuj xyoo 2024, IPP muab cov nyiaj them rau cov neeg ua haujlwm hauv MCP kom lawv thiaj li pab tau thiab nthuav CalAIM. Lub hom phiaj ntawm IPP yog los tsav kev hloov pauv ntawm MCP thiab theem tus neeg muab kev pab los ntawm kev tsim kom muaj peev xwm tsim nyog thiab ruaj khov; nqis peev rau hauv cov txheej txheem kev xa khoom tsim nyog; txuas cov silos tam sim no hla kev muab kev pabcuam kev noj qab haus huv lub cev thiab tus cwj pwm; txo qhov tsis sib xws ntawm kev noj qab haus huv thiab txhawb kev ncaj ncees ntawm kev noj qab haus huv; ua tiav kev txhim kho hauv kev ua tau zoo; thiab txhawb kom MCP siv Cov Kev Txhawb Nqa Hauv Zej Zog. Yog xav paub ntxiv, thov mus saib nplooj ntawv web ECM thiab Community Supports.​​ 
  • CalAIM Muab Kev Nkag Mus Nkag thiab Hloov Kho Kev Noj Qab Haus Huv (PATH): Lub Ib Hlis, DHCS yuav tshaj tawm cov koom haum uas tau txais nyiaj pab los ntawm kev pib puag ncig (Round 1) ntawm CalAIM PATH: CITED teg num. PATH CITED teg num muab nyiaj pab rau kev hloov pauv, nthuav dav, thiab txhim kho ECM thiab Zej Zog Txhawb kev muaj peev xwm thiab kev tsim kho vaj tse. Cov koom haum hauv zej zog, tsev kho mob pej xeem, cov koom haum hauv nroog, Pawg Neeg, thiab lwm tus neeg muab kev pabcuam hauv zej zog muaj cai thov thaum lub sijhawm CITED nyiaj pab Round 2 daim ntawv thov lub qhov rais thaum Lub Ob Hlis. Thaum Lub Ib Hlis, DHCS tseem yuav nthuav tawm Kev Pabcuam Kev Pabcuam (TA) Kev Lag Luam rau cov neeg thov uas yuav muab cov chaw koom nrog CalAIM muaj peev xwm tau txais kev txhawb nqa thiab kev pabcuam. Yog xav paub ntxiv txog TA Marketplace, thov mus saib PATH lub vev xaib.​​ 

Ob peb lwm qhov kev pabcuam tseem ceeb pib los online Lub Ib Hlis 1, 2023, suav nrog:​​ 

  • Cov Kev Pabcuam Doula ua ib qho txiaj ntsig Medi-Cal: Tom qab ua haujlwm nrog cov neeg koom tes ntau tshaj ib xyoos los tsim cov txiaj ntsig, DHCS yuav pib them cov kev pabcuam doula hauv ob qho tib si kev them nqi rau kev pabcuam thiab kev tswj hwm kev saib xyuas. Cov kev pabcuam Doula yog lub hom phiaj los tiv thaiv cov teeb meem perinatal thiab txhim kho cov txiaj ntsig kev noj qab haus huv rau cov niam txiv thiab cov menyuam mos yug menyuam. Cov kev pab cuam suav nrog kev txhawb nqa tus kheej rau cov poj niam thiab tsev neeg thoob plaws lub sijhawm cev xeeb tub, yug menyuam, thiab tom qab yug menyuam. Qhov no suav nrog kev txhawb nqa lub siab thiab lub cev thaum cev xeeb tub, yug menyuam, yug menyuam, thiab tom qab yug menyuam. Tam sim no Doulas yuav muaj peev xwm xa lawv daim ntawv thov rau npe Medi-Cal los ntawm PAVE portal, lub portal tsim los ua kom yooj yim thiab ua kom cov txheej txheem rau npe Medi-Cal sai dua. DHCS tau xa Daim Ntawv Hloov Kho Txoj Kev Npaj Xeev 22-0002 mus rau Lub Chaw rau Medicare & Medicaid Services (CMS) thaum Lub Kaum Ib Hlis 7, 2022, los ntxiv cov kev pabcuam doula ua ib qho txiaj ntsig Medi-Cal uas them.​​  
  • Dyadic Services as a Medi-Cal Benefit: Dyadic services – such as Behavioral Health Well-Child Visits, specific assessment, screening, counseling, and brief intervention services – are a set of services provided specifically to a “dyad”: a child along with their parent or caregiver. Services provided to the parent or caregiver include depression screening, behavioral health assessment and interventions, screening for social drivers of health, and alcohol and drug screening, assessment, brief interventions and referral to treatment, among other services.
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  • Cov Cuab Yeej Siv Los Tshuaj Xyuas thiab Hloov Chaw Saib Xyuas Kev Noj Qab Haus Huv ntawm Medi-Cal: Tom qab ua haujlwm nrog cov neeg koom tes tau ntau tshaj ib xyoos, DHCS tau ua tiav cov cuab yeej siv los tshuaj xyuas thiab hloov chaw saib xyuas cov neeg laus thiab cov hluas thoob plaws lub xeev rau Medi-Cal Mental Health Services. Nyob rau hauv CalAIM, DHCS tau ua kom yooj yim rau cov txheej txheem tshuaj xyuas kev noj qab haus huv ntawm lub hlwb thiab txhim kho kev saib xyuas tus neeg mob los ntawm kev tsim cov cuab yeej siv thoob plaws lub xeev los coj kev xa cov neeg laus thiab cov hluas mus rau qhov kev pabcuam kev noj qab haus huv ntawm lub hlwb Medi-Cal thiab xyuas kom meej tias cov tswv cuab uas xav tau kev hloov pauv ntawm cov kev pabcuam tau txais kev saib xyuas raws sijhawm thiab sib koom tes. Cov cuab yeej muaj nyob rau ntawm DHCS' Screening and Transition of Care Tools for Medi-Cal Mental Health Services nplooj ntawv web.​​ 

Lwm qhov kev tshaj tawm tseem ceeb thiab kev hloov pauv yav tom ntej suav nrog:​​ 

  • Txoj Cai Kho Mob Hauv Xov Tooj Tshiab: DHCS tab tom ua ntau yam kev hloov pauv ntawm kev kho mob hauv xov tooj mus tas li los ntawm COVID-19 qhov xwm txheej ceev ntawm kev noj qab haus huv pej xeem (PHE), suav nrog kev them nyiaj sib npaug thiab kev them nqi dav dav rau cov kev pabcuam kho mob hauv xov tooj uas tsim nyog rau kev kho mob. Txoj cai tshiab yuav raug tshaj tawm rau lub Ib Hlis 16 hauv Phau Ntawv Qhia Txog Kev Muab Kev Pabcuam Medi-Cal rau kev kho mob hauv xov tooj, uas yuav muaj cov lus qhia txog kev pom zoo, kev tsim cov neeg mob tshiab los ntawm kev kho mob hauv xov tooj, cov lus qhia txog kev them nqi rau cov kev pabcuam uas muab los ntawm kev siv suab xwb, thiab kev sib txuas lus luv luv thiab kev kuaj xyuas hauv online.​​   

Tag nrho cov kev hloov pauv tam sim no uas tau tshaj tawm thaum lub sijhawm PHE yuav nyob twj ywm ntev npaum li PHE tseem siv tau, thiab cov kev hloov pauv feem ntau nyob rau hauv qhov chaw thaum lub sijhawm PHE yuav txuas ntxiv tom qab tas sijhawm ntawm PHE. Thaum lub sijhawm PHE, cov kws kho mob yuav tsum sab laj nrog Medi-Cal Telehealth Phau Ntawv Qhia thiab lwm yam kev taw qhia PHE ntxiv los coj lawv cov kev pabcuam. Tom qab PHE tas lawm, cov kws kho mob yuav tsum sab laj rau Medi-Cal Telehealth Phau Ntawv Qhia.​​  

  • Hearing Aid Coverage for Children Program (HACCP) Eligibility Expansion: Beginning January 1, DHCS welcomes newly eligible young adults ages 18 to 20 who meet other program criteria and need coverage for their hearing aid(s) and related services to apply for HACCP enrollment. Also, effective January 1, applicants under age 21 who meet program eligibility requirements may apply to enroll in HACCP even if they have partial other health coverage for hearing aids subject to a coverage limit of $1,500 or less per year. Additional program information is available on the HACCP webpage. Families can apply to enroll for coverage through HACCP’s Online Application Portal.
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  • Kev Pabcuam Hauv Zej Zog, Kev Rov Qab Los, thiab Kev Pabcuam (CARE) Txoj Cai Hloov Kho: DHCS ua haujlwm nrog California Health & Human Services Agency thiab Judicial Council of California los muab kev sib txuas lus zoo ib yam thiab tsim kev cob qhia rau CARE Act muaj feem xyuam. Txoj Cai CARE tsim txoj hauv kev tshiab los xa cov kev pabcuam kev puas siab puas ntsws thiab kev siv tshuaj yeeb dawb rau cov neeg California uas muaj kev puas tsuaj loj tshaj plaws uas feem ntau raug kev txom nyem hauv tsev tsis muaj tsev nyob lossis raug kaw yam tsis muaj kev kho mob. DHCS yuav pib kev cob qhia thawj zaug thiab kev pab cuam rau lub nroog cov koom haum saib xyuas kev noj qab haus huv los txhawb kev siv Txoj Cai CARE thaum lub caij nplooj ntoo hlav xyoo 2023. Xya lub nroog yuav siv txoj haujlwm pib lub Kaum Hli 1, 2023, thiab cov nroog tseem tshuav tsis pub dhau lub Kaum Ob Hlis 1, 2024.
     
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  • Mobile Crisis Services Benefit: On December 19, DHCS released BHIN 22-064  providing guidance for implementation of the Mobile Crisis Services Benefit on January 1. Mobile crisis services are a community-based intervention designed to provide de-escalation and relief to individuals experiencing a behavioral health crisis wherever they are, reducing unnecessary law enforcement involvement and emergency department utilization. Mobile crisis services are provided year-round by a multidisciplinary team of trained behavioral health professionals in the least restrictive setting. Mobile crisis services include screening, assessment, stabilization, de-escalation, follow-up, and coordination with health care services and other supports.​​ 
  • Kev Pab Txhawb Nqa Kev Rov Qab Zoo - California Txoj Kev Tswj Xyuas Kev Sib Tw (CM): Hauv peb lub hlis thawj zaug ntawm xyoo 2023, DHCS yuav sim ua qhov kev pab cuam Medi-Cal ntawm CM hauv cov nroog xaiv Drug Medi-Cal Organized Delivery System (DMC-ODS) los ntawm Kev Pab Txhawb Nqa Kev Rov Qab Zoo. Ua ib feem ntawm CalAIM, California tau los ua thawj lub xeev hauv lub tebchaws uas tau txais kev pom zoo los ntawm tsoomfwv los them rau cov kev pabcuam CM rau kev siv tshuaj yeeb dej cawv (SUD). CM yog ib qho kev kho mob uas muaj pov thawj thiab pheej yig rau SUD. DHCS npaj siab siv qhov kev sim ua lub hauv paus rau kev qhia txog kev tsim thiab kev siv ntawm cov txiaj ntsig CM thoob plaws lub xeev los ntawm DMC-ODS qhov kev pab cuam, tos txog kev tswj hwm nyiaj txiag thiab kev cai lij choj.​​ 

Kev hloov kho tshiab​​ 

Whole Person Care (WPC) Pilot Program Final Evaluation Report​​ 

Thaum Lub Kaum Ob Hlis 23, DHCS tau xa daim ntawv qhia txog kev ntsuam xyuas zaum kawg ntawm WPC pilot program rau CMS. Qhov kev pab cuam sim WPC yog ib qho kev pab cuam ua qauv qhia nyob rau hauv California txoj kev zam Medi-Cal 2020 uas tau xaus rau lub Kaum Ob Hlis 31, 2021. Lub hom phiaj ntawm qhov kev pab cuam no yog kom ua tiav kev saib xyuas zoo dua, kev noj qab haus huv zoo dua, thiab txo cov nqi rau cov tswv cuab Medi-Cal hauv California thaum txhawb kev sib koom tes ntawm kev noj qab haus huv, kev noj qab haus huv tus cwj pwm, thiab kev pabcuam hauv zej zog hauv txoj kev uas tsom mus rau tus neeg mob.​​ 

Daim ntawv ntsuam xyuas zaum kawg, uas tau tsim los ntawm UCLA Center for Health Policy Research, pom tias cov kev pab cuam sim tau ua tiav hauv kev tsim cov khoom siv sib txawv thiab tsim nyog, sib qhia cov ntaub ntawv thoob plaws cov sectors, thiab siv cov txheej txheem ntaub ntawv tshiab. Ntxiv mus, cov kev sim tau ua tiav hauv kev xa cov kev pabcuam sib koom tes saib xyuas, ua rau kev noj qab haus huv ntawm cov tswv cuab zoo dua, txo qis kev mus ntsib chav kho mob ceev, thiab txo qis kev siv cov neeg mob hauv tsev kho mob. Cov kev pab cuam uas tau ua tiav los ntawm qhov kev pab cuam tau txo cov nqi ntawm cov tswv cuab los ntawm $ 99 rau ib tus neeg sau npe hauv ib xyoos. Cov kev tsim kho vaj tse thiab kev koom tes uas tau tsim thaum lub sijhawm WPC tau ua rau muaj kev hloov pauv mus rau CalAIM's ECM thiab Kev Txhawb Nqa Hauv Zej Zog. Daim ntawv qhia txog kev ntsuam xyuas zaum kawg yuav raug tshaj tawm rau ntawm nplooj ntawv web Medi-Cal 2020 Evaluations thaum kawg ntawm lub Ib Hlis.​​ 

Youth Opioid Response California 3 (YOR 3) Daim Ntawv Thov​​ 

DHCS released a RFA to strengthen capacity and access to prevention, treatment, and recovery services, as well as access points to Medication-Assisted Treatment (MAT), for youth (ages 12-24) and their families. This opportunity is designed to foster the coordination and strengthening of existing multi-system networks and encourage the development of new partnerships between agencies reaching youth. Implementation grantees may receive up to $750,000 and capacity building grantees may receive up to $50,000. For more information and to apply by the January 19 deadline, please visit the YOR CA website or email YORCalifornia@ahpnet.com.​​ 

MAT thiab California Hub and Spoke (CA H&SS) Awards​​ 

Thaum Lub Ib Hlis 9, DHCS yuav muab $ 52 lab rau 105 lub koom haum uas muab kev pabcuam MAT los siv CA H&SS txij Lub Ib Hlis 1, 2023, mus txog Lub Rau Hli 30, 2024. Txhua lub koom haum yuav tau txais ntawm $ 100,000 - $ 1,848,000 txhua xyoo los pab nyiaj rau kev tiv thaiv, kev soj ntsuam, kev kuaj mob, kev kho mob, thiab kev rov zoo los ntawm kev siv tshuaj opioid thiab kev siv tshuaj yeeb dej cawv. Lub cib fim nyiaj txiag no yuav raug siv los txhawb kev tsim kho thiab kev siv cov "Hubs" hauv cheeb tsam (Regional Centers of Excellence in MAT) thiab "Spokes" (txhua tus kws kho mob uas tau tso cai los ntawm tsoomfwv DATA-2000 uas tau tso cai uas tau sau ntawv lossis muab tshuaj buprenorphine) los txhim kho kev saib xyuas opioid thiab kev siv tshuaj yeeb dej cawv. Qhov project no tau txais nyiaj los ntawm State Opioid Response (SOR) III grant, uas tau muab los ntawm Substance Abuse and Mental Health Services Administration (SAMHSA), thiab yog tswj hwm los ntawm Advocates for Human Potential, Inc. (AHP). Yog xav paub ntxiv, mus saib lub vas sab hauv internet ntawm MAT.​​ 

Kev Hloov Kho Hauv Tsev thiab Hauv Zej Zog (HCBA) thiab Medi-Cal Waiver Program (MCWP) Kev Hloov Kho Tshiab​​ 

Thaum Lub Kaum Ob Hlis 20, DHCS tau xa cov lus teb raug cai rau CMS Daim Ntawv Thov Ntxiv kom rov tso cai rau HCBA thiab MCWP cov kev zam. Cov sijhawm zam HCBA thiab MCWP tam sim no tau teem sijhawm xaus rau lub Kaum Ob Hlis 31, 2021. Thaum Lub Kaum Ob Hlis 13, CMS tau pom zoo rau qhov kev ncua sijhawm thib tsib kom tso cai rau HCBA thiab MCWP cov kev zam kom txuas ntxiv ua haujlwm mus txog rau Lub Peb Hlis 26, 2023. CMS yuav pom zoo rau kev txuas ntxiv HCBA thiab MCWP thaum Lub Ib Hlis 2023. Vim yog qhov kev ncua sij hawm hauv cov txheej txheem tshuaj xyuas thiab kev pom zoo, CMS thiab lub xeev tau pom zoo ncua hnub siv ntawm HCBA thiab MCWP cov kev zam tshiab mus rau Lub Ib Hlis 1, 2023, uas txuas ntxiv cov sij hawm zam tshiab mus txog thaum kawg ntawm xyoo 2027.

Kev txuas ntxiv HCBA suav nrog ntau qhov kev hloov tshiab tseem ceeb, suav nrog, tab sis tsis txwv rau:​​ 

  • Ua kom muaj peev xwm zam tag nrho​​ 
  • Hloov kho yam tsawg kawg nkaus rau cov kev tsim nyog ntawm tus neeg ua haujlwm tus neeg saib xyuas tus neeg ua haujlwm​​ 
  • Txhais lub luag hauj lwm ntawm lub voj voog ntawm kev txhawb nqa nyob rau hauv lub zam​​ 
  • Added Assistive Technology as a waiver service, to maintain the participant’s health and safety​​ 
  • Tshem tawm qhov txwv hnub nyoog rau Respite thiab Habilitation Services​​ 
  • suav nrog Pediatric Day Health Care ua ib hom kev kho mob rau cov kev pab cuam Respite raws li qhov chaw​​ 
  • Ntxiv cov kev pabcuam kws khomob raws li kev pabcuam hauv lub xeev txuas ntxiv​​ 

The MCWP renewal includes a limited number of significant updates, including:​​ 

  • Hloov kho lub npe zam​​ 
  • Hloov kho yam tsawg kawg nkaus rau Social Worker Case Manager Qualifications​​ 
  • Hloov ncua sij hawm rau kev ntsuam xyuas​​ 
  • Ntxiv cov nqi txwv​​ 
  • Hloov kho cov neeg ua haujlwm rau cov neeg siv khoom sib piv​​ 

Intimate Partner Violence (IPV) Kev Ntsuam Xyuas thiab Kev Xa Mus Rau Medicaid Primary Care Clinicians​​ 

There is an upcoming invitation-only survey for Medicaid primary care clinicians who treated adult (18 years of age or older) Medicaid members in 2021. The Office of Evaluation and Inspections, a component of the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS), is conducting a study on challenges faced by primary care clinicians related to intimate IPV screening and referrals beginning January 9 on a rolling basis. The survey will focus on clinicians’ IPV screening (which is a recommended screening by the U.S. Preventive Services Task Force, referral practices, the challenges they encounter related to these services, and potential measures that might improve the screening for IPV. The survey is voluntary, and clinicians’ responses will be anonymous. Responses will be aggregated and will be used to help make recommendations to address the screening of patients experiencing IPV.​​ 

Cov kws kho mob tuaj yeem nrhiav cov ntaub ntawv ntxiv txog tsoomfwv txoj kev tshawb fawb no thiab FAQs ntawm HHS-OIG lub vev xaib. Yog xav paub ntxiv, email IPVsurvey@oig.hhs.gov.​​ 

Koom nrog peb pab neeg​​ 

DHCS is hiring Californians to join our fiscal, human resources, legal, auditing, health policy, and information technology teams. For more information, please visit the CalCareers website.​​ 

DHCS is dedicated to preserving and improving the overall health and well-being of all Californians. DHCS’ mission is to provide the most vulnerable residents with equitable access to affordable, integrated, high-quality health care, and the Department is currently transforming the Medi-Cal program to make sure it provides the quality-focused and person-centered care Californians need to live healthier, happier lives.​​ 

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

Children and Youth Behavioral Health Initiative (CYBHI) Webinars​​ 

Thaum Lub Ib Hlis 13 thiab 20, txij 2 txog 3 teev tsaus ntuj, DHCS yuav tuav cov webinars online (yuav tsum tau sau npe ua ntej) sawv cev rau CYBHI Evidence-Based thiab Community-Defined Evidence Practices grants program. Cov webinars no yuav tsom mus rau Qhov Thib Ib: Cov Kev Pabcuam thiab Kev Xyaum ntawm Niam Txiv thiab Tus Saib Xyuas RFA. DHCS lub hom phiaj yog los muab kev pab txog kev siv tshuab los ntawm kev sib qhia cov lus teb rau cov lus nug uas nquag nug raws li cov ntsiab lus. Thaum lub sijhawm webinars, DHCS yuav tsis teb cov lus nug tam sim ntawd. Thov xa email rau cov lus nug ntsig txog qhov kev sib tw thib ib mus rau CYBHI@dhcs.ca.gov. DHCS yuav tshaj tawm cov FAQs rau CYBHI nplooj ntawv web thaum Lub Ib Hlis 9.​​ 

CalAIM Kev tshuaj ntsuam xyuas thiab hloov pauv cov cuab yeej saib xyuas​​ 

Thaum Lub Ib Hlis Ntuj Tim 19, thaum 3 txog 4 teev tsaus ntuj, DHCS yuav muaj kev sib tham hauv webinar txog Kev Tshuaj Ntsuam Xyuas Cov Neeg Laus thiab Cov Hluas thiab Hloov Kho Cov Cuab Yeej (yuav tsum tau sau npe ua ntej) rau Medi-Cal Mental Health Services pib. Qhov kev pib no yog tsom mus rau kev siv thoob plaws lub xeev Kev Tshuaj Ntsuam Xyuas thiab Hloov Kho Cov Cuab Yeej Kho Mob rau cov neeg laus thiab cov neeg muaj hnub nyoog qis dua 21 xyoos rau kev siv los ntawm Medi-Cal MCPs thiab County Mental Health Plans (MHPs). Lub webinar yuav suav nrog cov ntsiab lus ntawm lub hom phiaj ntawm kev pib, kev tshuaj xyuas cov lus qhia zaum kawg thiab cov cuab yeej, thiab cov lus teb rau cov lus nug nquag. Lub sijhawm yuav tau tseg thaum kawg ntawm qhov webinar rau cov lus nug thiab lus teb. Yog xav paub ntxiv, thov mus saib qhov Kev Ntsuam Xyuas thiab Kev Hloov Pauv ntawm Cov Cuab Yeej Kho Mob lub vev xaib.​​ 

HACCP Tus Muab Kev Pabcuam Webinar​​ 

Thaum Lub Ib Hlis Ntuj hnub tim 24, txij thaum 12 teev txog 12:50 teev tsaus ntuj, DHCS yuav tuav lub rooj sib tham hauv webinar (yuav tsum tau sau npe ua ntej) los pab cov neeg muab kev pab nrog cov ntaub ntawv los pab cov neeg mob menyuam yaus thiab lawv tsev neeg kom tau txais txiaj ntsig zoo tshaj plaws ntawm HACCP. Lub rooj cob qhia yuav hais txog cov kev cai ntawm qhov kev pab cuam rau cov tsev neeg thov kev pab them nqi thiab cov txheej txheem xa cov ntawv thov rau cov kws kho mob hnov lus, kws kho mob otolaryngologists, lwm tus kws kho mob, thiab lawv cov neeg ua haujlwm hauv chaw ua haujlwm.​​ 

Hauv Case Koj Tsis Tau Nws​​ 

Consolidated Appropriations Act of 2023 thiab Medi-Cal Redeterminations​​  

Thaum Lub Kaum Ob Hlis 29, Thawj Tswj Hwm Biden tau kos npe rau hauv txoj cai lij choj Consolidated Appropriations Act of 2023 (omnibus spending bill), uas muaj ntau yam cuam tshuam rau Medi-Cal program thiab tshwj xeeb tshaj yog qhov rov pib dua ntawm Medi-Cal kev txiav txim siab dua. Yav dhau los, qhov rov pib dua ntawm Medi-Cal kev txiav txim siab dua tau khi rau kev xaus ntawm COVID-19 kev noj qab haus huv pej xeem (PHE). Thaum tsab cai lij choj no dhau los, cov kev cai tswjfwm uas txuas ntxiv mus uas tau ncua tag nrho cov kev txiav txim siab dua ntawm Medi-Cal txij li lub Peb Hlis 2020 yuav raug tshem tawm ntawm hnub xaus ntawm PHE txij li lub Plaub Hlis 1, 2023, teeb tsa theem rau kev rov pib dua ntawm kev txiav txim siab dua ntawm Medi-Cal.

CMS yuav muab cov lus qhia tshiab rau cov xeev lub hlis no txog qhov kev pab cuam Medicaid.  DHCS yuav hloov kho Medi-Cal COVID-19 PHE Operational Unwinding Plan thiab cov lus qhia ntxiv, lub nroog thiab cov kws kho mob thaum CMS tso tawm cov lus qhia tshiab.  

DHCS yuav ua haujlwm nrog txhua tus Neeg Sawv Cev Kev Pabcuam los qhia cov ntaub ntawv tshiab rau cov tswv cuab Medi-Cal thoob plaws California. Cov tib neeg tuaj yeem koom nrog daim ntawv teev npe xa ntawv ntawm DHCS Coverage Ambassador kom tau txais cov ntaub ntawv tshiab tshaj plaws thiab cov cuab yeej hloov tshiab thaum lawv muaj. Yog koj muaj lus nug, thov email rau Ambassadors@dhcs.ca.gov.​​ 

ECM thiab zej zog txhawb nqa cov ntaub ntawv ua tiav thaum ntxov​​ 

Thaum Lub Kaum Ob Hlis 22, DHCS tau tshaj tawm cov ntaub ntawv pib ua ntej rau ECM thiab Kev Txhawb Zej Zog, ob qhov kev pabcuam CalAIM loj uas tau pib xyoo 2022. ECM thiab Kev Pabcuam Zej Zog tau tsim los pab txhawb cov tswvcuab Medi-Cal uas xav tau ntau thiab hais txog kev cuam tshuam txog kev noj qab haus huv, xws li vaj tse thiab khoom noj khoom haus. Cov ntaub ntawv qhia txog thaum ntxov ntawm ECM thiab Kev Txhawb Zej Zog hauv lub Ib Hlis mus txog rau Lub Rau Hli, thiab qhia txog kev loj hlob ntawm cov tswv cuab hauv ob qho kev pab cuam, tshwj xeeb tshaj yog cov neeg tsis tau txais kev pab yav dhau los.​​ 

Cov ntaub ntawv them nqi kho mob tus kws kho mob Medicare rau cov neeg mob tau txais kev pab dual​​ 

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 (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.​​ 

Tshaj tawm cov ntaub ntawv COVID-19​​