DHCS Stakeholder News – July 21, 2023
Xov xwm tshaj plaws
Medi-Cal Hloov Kho Tshiab
Thaum Lub Xya Hli 20, DHCS tau saib ua ntej cov ntaub ntawv txuas ntxiv Medi-Cal rau lub Rau Hli 2023, thawj lub hlis ntawm California qhov kev txiav txim siab dua txij li qhov kawg ntawm qhov yuav tsum tau them nqi txuas ntxiv mus ntawm tsoomfwv. Ntau tshaj 81 feem pua ntawm 1,052,030 tus tswv cuab Medi-Cal uas tsim nyog rau kev txuas ntxiv daim ntawv pov hwm thaum Lub Rau Hli tau xa lawv cov ntaub ntawv mus rau cov chaw ua haujlwm hauv nroog kom tshuaj xyuas lossis ua tiav lawv cov kev txuas ntxiv los ntawm ex parte. Thaum Lub Xya Hli 1, California tau rho tawm kwv yees li 225,000 tus tswv cuab Medi-Cal rau lub hlis Rau Hli, uas yog 21 feem pua ntawm kev rho tawm.
Ua ntej qhov kev xav tau ntawm COVID-19 tsis tu ncua, California feem ntau yuav pom tus nqi rho tawm ntawm 18-20 feem pua. Txawm li cas los xij, qhov ntawd yog tom qab lub sijhawm kho 90-hnub (thaum cov tswvcuab uas raug rho npe tuaj yeem xa rov qab cov ntaub ntawv tsim nyog los rov muab lawv cov kev pab cuam rov qab mus rau lawv qhov qub hnub tshiab), uas rau lub Rau Hli kev rho npe yuav yog thaum lub Cuaj Hli. Keeb kwm, Kalifonias tau pom tus nqi rov qab los ntawm kwv yees li 4 feem pua nyob rau lub sijhawm kho 90 hnub; yog li ntawd, California tab tom npaj qhov kev rho npe tawm ze dua rau 17 feem pua tom qab lub sijhawm kho. DHCS yuav tshaj tawm cov nqi rho npe tawm rau lub Rau Hli kawg thaum Lub Kaum Hli.
Yog tias hnub uas ib tug tswv cuab rov ua dua tshiab tsim nyog yog thaum Lub Rau Hli, ces tseem tsis tau lig dhau. Lawv muaj sijhawm txog rau thaum kawg lub Cuaj Hli los xa lawv cov pob ntawv txuas ntxiv Medi-Cal mus rau lub chaw haujlwm hauv nroog kom rov qab tau lawv cov kev pov hwm rov qab mus rau hnub txuas ntxiv thawj zaug. Yog cov tswv cuab tau txais pob ntawv txuas ntxiv Medi-Cal hauv xa ntawv thiab muab tso rau hauv lub hnab ntawv daj, lawv yuav tsum ua sai sai kom lawv thiab lawv tsev neeg tau txais kev pab them nqi los ntawm kev xa cov ntaub ntawv txuas ntxiv rov qab. DHCS cog lus tias yuav ua haujlwm nrog cov tswv cuab Medi-Cal hauv qhov kev siv zog no thiab txaus siab uas peb muaj ntau txhiab tus neeg koom tes pab peb ua ntau hom lus, kev ncav tes mus rau cov tswv cuab uas tsim nyog rau kab lis kev cai.
Medi-Cal Targeted Provider Rate nce
Raws li Txoj Cai Lij Choj Nyiaj Txiag ntawm 2023 thiab Tsab Cai Sib Koom Tes (AB) 118 (Tshooj 42, Txoj Cai ntawm 2023), DHCS tab tom txhim kho tus kws kho mob tus nqi nce rau kev saib xyuas thawj zaug, obstetric, thiab tsis tshwj xeeb kev kho mob hlwb, siv tau los yog tom qab Lub Ib Hlis Ntuj 1, 2024, nyob rau hauv Medi-Service Management Systems (FF).
These investments will support DHCS’ Comprehensive Quality Strategy and its clinical focus on children’s preventive care, maternal care and birth equity, and behavioral health integration—aligning our efforts toward upstream preventive and primary care interventions. DHCS published the proposed procedure code list and additional information on the DHCS website. Additional information, including a public notice of the upcoming State Plan Amendment (SPA), will be published on the DHCS website in the coming weeks.
Kev hloov kho tshiab
Kev pom zoo ntawm Community-Based Mobile Crisis Intervention SPA
Thaum Lub Xya Hli 20, Lub Chaw rau Medicare & Medicaid Services (CMS) tau pom zoo SPA 22-0043, uas ntxiv cov kev pabcuam cuam tshuam kev kub ntxhov hauv zej zog rau California's Medicaid State Plan ua qhov txiaj ntsig rov qab tau txij li Lub Ib Hlis 1, 2023. Tag nrho 58 lub nroog yuav siv qhov txiaj ntsig no, ua rau muaj kev pabcuam thaum muaj xwm txheej ceev hauv xov tooj ntawm tes 24 teev hauv ib hnub, 7 hnub hauv ib lub lim tiam, 365 hnub hauv ib xyoos. Cov kev pabcuam pabcuam thaum muaj xwm txheej ceev ntawm xov tooj ntawm tes muab kev pabcuam rau cov tswv cuab uas muaj teeb meem kev noj qab haus huv ntawm tus cwj pwm, nthuav dav cov kev siv zog cuam tshuam los txhawb kev saib xyuas kev kub ntxhov, xws li 988 Suicide and Crisis Lifeline, uas muab kev txhawb nqa ib leeg 24/7, kev pabcuam thaum muaj xwm txheej ceev thiab kev txo qhov teeb meem, thiab cov ntaub ntawv thiab kev xa mus rau cov neeg hu xov tooj txuas nrog rau cov peev txheej hauv zej zog hauv lawv lub nroog lossis lub nroog. Yog xav paub ntxiv, thov nyeem CMS cov ntawv xov xwm.
Tus Cwj Pwm Kev Noj Qab Haus Huv Kev Them Nqi Them Nqi SPA
Thaum Lub Xya Hli 20, CMS tau pom zoo SPA 23-015, CalAIM txoj kev pib hloov kho kev them nyiaj rau kev noj qab haus huv ntawm tus cwj pwm, uas siv tau rau Lub Xya Hli 1, 2023, uas tso cai rau DHCS hloov cov nroog los ntawm kev them rov qab raws li tus nqi uas tau txais nyiaj los ntawm Kev Siv Nyiaj rau Pej Xeem uas tau ntawv pov thawj mus rau kev them rov qab FFS uas tau txais nyiaj los ntawm Kev Hloov Pauv ntawm Tsoom Fwv Tebchaws kom tshem tawm qhov xav tau kev sib haum xeeb rau cov nqi tiag tiag. Kev siv txoj haujlwm no yuav tso cai rau DHCS txhim kho kev tshaj tawm thiab txhawb kev txiav txim siab raws li cov ntaub ntawv los ntawm kev faib cov ntaub ntawv ntawm cov kev pabcuam kev noj qab haus huv tshwj xeeb thiab ua raws li CMS cov kev cai kom txais yuav Cov Lus Cog Tseg Tam Sim No hloov chaw ntawm Lub Txheej Txheem Kev Kho Mob dav dav.
DHCS tau piav qhia ntau tshaj 10 txoj kev them nqi tshwj xeeb ua rau muaj ntau tshaj 40,000 tus nqi tshiab thiab sib txawv, uas yuav raug them rau cov nroog rau cov kev pabcuam kev noj qab haus huv tshwj xeeb thiab cov kev pabcuam kev siv tshuaj yeeb dej cawv (SUD) ntawm FFS. Qhov kev pom zoo no yog thaum kawg ntawm plaub xyoos ntawm kev tsim kho thiab kev koom tes nrog California Behavioral Health Directors Association thiab cov neeg koom nrog cov kws kho mob kom txo cov nroog thiab cov kws kho mob ntawm cov kev nyuaj siab ntawm kev tswj hwm nyiaj txiag.
Kev Ncaj Ncees thiab Kev Xyaum Hloov Kev Them Nyiaj Them Nqi
DHCS tab tom siv ib qho kev pab cuam hloov pauv kev coj ua ntawm cov neeg muab kev pab ib zaug uas muaj nqis $ 700 lab ($ 350 lab Nyiaj Txiag Dav Dav) los txhawb kev ncaj ncees ntawm kev noj qab haus huv thiab txo qhov sib txawv ntawm kev saib xyuas uas tsav los ntawm COVID-19. Qhov kev pib no yuav nqis peev rau cov qauv kev saib xyuas sab saud thiab kev koom tes los daws teeb meem kev noj qab haus huv thiab kev nyob zoo thiab hloov pauv kev siv nyiaj txiag kom cov neeg muab kev pabcuam Medi-Cal tuaj yeem pabcuam cov tswv cuab Medi-Cal ntawm lub xeev tau zoo dua.
Cov nyiaj pab kev sib tw no yuav raug muab tsub rau hauv ib txoj hauv kev theem. Thawj theem ntawm qhov kev zov me nyuam yog Medi-Cal Managed Care Plan (MCP) Qhov Kev Pab Them Pib Pib Npaj Kev Txhawb Kev Them Nyiaj ($ 25 lab), uas yuav tso cai rau MCPs txheeb xyuas thiab ua haujlwm nrog me me rau nruab nrab cov kev ua haujlwm ywj pheej siv cov cuab yeej ntsuas tus qauv los txhawb cov kev coj ua thaum lawv tsim cov phiaj xwm hloov pauv thiab cov ntawv thov.
Yog xav paub ntxiv, thov mus saib Equity and Practice Transformation Payments Program webpage.
DAIM NTAWV THOV KEV PAB CUAM TSHUAJ TIV THAIV: Cov Nyiaj Them Nqi Kho Mob rau Kev Pabcuam Hauv Tsev thiab Hauv Zej Zog (HCBS) Cov Neeg Ua Haujlwm Ncaj Ncees
Thaum Lub Rau Hli 12, DHCS tau qhib daim ntawv thov rau Kev Them Nyiaj Kho Mob rau HCBS Cov Neeg Ua Haujlwm Ncaj Ncees. Thaum Lub Xya Hli 10, DHCS tau txuas ntxiv hnub kawg ntawm kev xa mus rau Lub Xya Hli 28, 2023. DHCS txhawb kom xa daim ntawv thov ntxov kom muaj sijhawm txaus rau kev siv tau thiab ua tiav ua ntej hnub kawg. DHCS cia siab tias yuav tshaj tawm cov nyiaj them rau cov koom haum muab kev pom zoo thaum lub Kaum Ib Hlis 2023, thiab cov neeg thov tau txais nyiaj yuav tsum tau them nyiaj rau cov neeg ua haujlwm tsim nyog hauv 60 hnub tom qab tau txais cov nyiaj. Txhawm rau nkag mus rau daim ntawv thov thiab kev txhawb nqa kev taw qhia, thov mus saib Cov Nyiaj Them Nqi Kho Mob rau HCBS Direct Care Workers lub vev xaib. Cov lus nug ntxiv tuaj yeem xa mus rau HCBSCareEconomyPayments@dhcs.ca.gov.
Koom nrog peb pab neeg
DHCS tab tom ntiav! DHCS muaj qhov qhib tam sim ntawd rau Tus Thawj Saib Xyuas Haujlwm, Cov Ntaub Ntawv Qhia Txog Kev Pabcuam, hauv Enterprise Cov Ntaub Ntawv thiab Kev Tswj Xyuas Cov Ntaub Ntawv. Lub luag haujlwm ntawm tus thawj tswj hwm no ua tus thawj tswj hwm tus thawj tswj hwm thiab tus kws pab tswv yim hauv kev txhawb nqa ntawm kev txheeb xyuas cov ntaub ntawv thiab tshaj tawm cov haujlwm.
DHCS tseem tab tom ntiav rau peb cov nyiaj txiag, tib neeg cov peev txheej, kev cai lij choj, kev tshuaj xyuas, kev noj qab haus huv txoj cai, thiab pab pawg xov xwm thev naus laus zis. Yog xav paub ntxiv, thov mus saib hauv CalCareers lub vev xaib.
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 is currently transforming the Medi-Cal program to make sure it provides the care Californians need to live healthier, happier lives.
Cov Rooj Sib Tham Cov Neeg Koom Tes thiab Webinar yuav los tom ntej
Smile, California Kev Sib Tw rau Medi-Cal Dental Services
Smile, California tau teem sijhawm dua rau Super Sealants rau Healthy Smile Webinar (yuav tsum tau sau npe ua ntej) mus rau Lub Xya Hli 26, txij 12 txog 1 teev tav su. Lub rooj sib tham hauv online no yog ib feem ntawm qhov kev sib tw Sealants for a Healthy Smile (SHS) uas lub hom phiaj yog txhawb nqa thiab txhawb kom muaj kev koom tes.
Ua ib feem ntawm kev txhawb nqa SHS, Smile, California tau koom tes nrog Smile Dental Services los npaj ib lub tsheb thauj khoom mus ncig xyuas hniav uas yuav tshwm sim txij lub Xya Hli 25 txog rau lub Kaum Hli 1, 2023. Qhov kev ncig xyuas yuav pib nrog kev tshaj xov xwm rau lub Xya Hli 25 ntawm nws qhov chaw nres thawj zaug hauv Sacramento ntawm CTLTRE Club.
Lub Chaw Saib Xyuas Kev Noj Qab Haus Huv Nyiaj Txiag Reform Stakeholder Webinar
Thaum Lub Xya Hli 27, thaum 2 txog 3 teev tsaus ntuj, DHCS yuav tuav lub vev xaib (yuav tsum tau sau npe ua ntej) los tham thiab sib sau ua ke cov tswv cuab ntawm Pawg Neeg Saib Xyuas Kev Ua Haujlwm Zoo & Kev Pabcuam Zoo, Txoj Haujlwm Pabcuam Kev Ua Haujlwm, thiab Kev Pabcuam Kev Txiav Txim Siab.
Yog xav paub ntxiv, mus saib hauv Nursing Facility Financing Reform (AB 186) webpage.
Kev Tshem Tawm Lub Rooj Sib Tham ntawm Pawg Neeg Saib Xyuas Kev Noj Qab Haus Huv Rau Menyuam Yaus (MCHAP) ntawm Medi-Cal
Lub Yim Hli 17 MCHAP lub rooj sib tham raug muab tso tseg. Vim lub sij hawm tas sij hawm ntawm Bagley-Keene waiver flexibilities nyob rau lub Xya hli ntuj 1, 2023, MCHAP cov rooj sib tham tam sim no yuav tsum muaj ib pawg ntawm cov tswv cuab lub cev nyob rau hauv thawj qhov chaw, raws li tsoom fwv Code tshooj 11123.5 thiab MCHAP phau ntawv qhia. Raws li kev teem caij tsis sib haum xeeb, lub rooj zaum tau siv nws qhov kev txiav txim siab kom tshem tawm lub rooj sib tham raws li Txoj Cai Welfare & Institutions Code tshooj 14005.271(j)(2), suav tias lub rooj sib tham tsis tsim nyog. Lub Kaum Ib Hlis 2 MCHAP lub rooj sib tham tseem tau teem sijhawm raws li tau npaj tseg.
Hearing Aid Coverage for Children Program (HACCP) Webinar rau Cov Kws Kho Mob thiab Cov Kws Kho Hniav
Thaum lub Cuaj Hlis 14, txij li 12 txog 1 teev tsaus ntuj, DHCS yuav tuav HACCP webinar (yuav tsum tau sau npe ua ntej) los qhia cov ntaub ntawv nrog cov kws kho mob los pab cov neeg mob me thiab lawv tsev neeg kom tau txais txiaj ntsig HACCP ntau tshaj plaws. Kev cob qhia yuav hais txog cov kev xav tau ntawm cov tsev neeg los thov kev pab them nqi thiab cov txheej txheem xa ntawv thov rau audiologists, otolaryngologists, kws kho mob, thiab lawv cov neeg ua haujlwm hauv chaw ua haujlwm.
Hauv Case Koj Tsis Tau Nws
Opioid thiab Stimulant Siv Kev Tiv Thaiv Kev Tiv Thaiv rau Cov Zej Zog ntawm Xim Project
Raws li ib feem ntawm Tus Thawj Kav Xeev Newsom txoj kev npaj $ 1 billion rau kev daws teeb meem Fentanyl thiab Opioid, DHCS tau muab $ 12.1 lab rau 54 lub koom haum los ntawm qhov project Opioid thiab Stimulant Use Disorder Prevention for Communities of Color. Qhov project no muab nyiaj pab rau cov koom haum uas tau ua pov thawj tias lawv tuaj yeem pab cov tib neeg hauv cov zej zog Dub, Indigenous, thiab People of Color (BIPOC) uas raug cuam tshuam ntau dhau los ntawm cov txiaj ntsig tsis zoo ntawm kev siv tshuaj thiab kev ua txhaum cai ntawm SUDs. Cov zej zog no suav nrog cov zej zog Native American, African American, Latino, thiab Asian-Pacific Islander thiab feem ntau muaj kev nkag mus rau kev kho mob thiab cov ntaub ntawv hais txog kev siv opioid thiab cov tshuaj stimulant thiab kev txhawb nqa tsawg dua, hauv California. Yog xav paub ntxiv, thov saib tsab xov xwm tshaj tawm thiab mus saib nplooj ntawv web MAT Expansion Project.