DHCS Stakeholder News – September 29, 2023
Xov xwm tshaj plaws
Tyler Sadwith xaiv rau Medicaid Pathways Program
Lub Chaw Saib Xyuas Kev Noj Qab Haus Huv (CHCS) tau tshaj tawm lub lim tiam no tias Tyler Sadwith, Tus Lwm Thawj Coj rau DHCS' Behavioral Health program, yog ib tus ntawm 20 tus thawj coj ntawm lub koom haum Medicaid uas tab tom loj hlob los ntawm thoob plaws lub tebchaws uas tau raug xaiv los koom nrog hauv chav kawm thib peb ntawm Medicaid Pathways Program. Tyler yog tus saib xyuas kev coj ua ntawm DHCS cov phiaj xwm loj kom ntseeg tau tias muaj cov kev pabcuam kev noj qab haus huv tshwj xeeb thiab kev siv tshuaj yeeb dej cawv zoo thiab yooj yim nkag tau hauv Medi-Cal thiab lwm cov kev pabcuam pej xeem. Nws yog tus coj pab pawg neeg saib xyuas kev noj qab haus huv ntawm Lub Chaw Haujlwm hauv kev tsim thiab siv cov tswv yim uas tsim los txhawb kev nkag mus rau kev kho mob kev noj qab haus huv ntawm tus cwj pwm, qhov zoo, kev sib luag, thiab kev muab kev pabcuam rau 15.5 lab tus tswv cuab Medi-Cal thiab cov neeg California uas tau txais kev pabcuam los ntawm cov kev pabcuam pej xeem.
Kev hloov kho tshiab
2024 Medi-Cal Managed Care Plan (MCP) Phau Ntawv Qhia Txog Kev Hloov Pauv
Thaum lub Cuaj Hlis 29, DHCS tau tso tawm ib daim ntawv kho dua tshiab ntawm 2024 MCP Txoj Cai Hloov Pauv uas suav nrog DHCS txoj cai thiab MCP cov kev cai ntsig txog kev hloov pauv ntawm cov tswv cuab ntawm Medi-Cal MCPs uas yuav siv tau rau lub Ib Hlis 1, 2024. Cov qauv tshiab tshaj plaws suav nrog txoj cai tshiab ntawm MCP uas saib xyuas thiab saib xyuas kev hloov pauv thiab cov kev cai ntsig txog kev hloov pauv rau cov kev pab cuam txhawb zog, nrog rau kev hloov kho rau txhua ntu. Daim ntawv qhia txoj cai yuav raug hloov kho tsis tu ncua kom MCPs tau txais kev qhia txog cov lus qhia tshiab thiab cov lus qhia uas tab tom txhim kho.
Muab Kev Nkag Mus Rau Thiab Hloov Kho Kev Noj Qab Haus Huv (PATH) Kev Pabcuam Txuj Ci (TA) Kev Lag Luam - Txoj Cai Nkag Mus Rau Tus Neeg Tau Txais TA uas Tau Kho Dua Tshiab
Thaum Lub Cuaj Hlis 29, DHCS tau tshaj tawm txoj cai hloov kho tshiab rau kev nkag mus rau cov peev txheej TA pub dawb uas muaj los ntawm PATH TA Marketplace. Txij li tam sim no, txhua tus neeg tau txais kev pom zoo TA tam sim no tuaj yeem nkag mus rau ob qho tib si cov haujlwm TA uas twb muaj lawm thiab cov haujlwm TA uas ua haujlwm tiag tiag hauv txhua xya qhov chaw TA, tsis hais lawv puas tau cog lus nrog MCP lossis lwm lub koom haum tsim nyog los muab Kev Tswj Xyuas Kev Kho Mob Zoo (ECM) thiab / lossis Kev Txhawb Nqa Hauv Zej Zog. Kawm paub seb cov kev pabcuam TA pub dawb uas muab los ntawm PATH TA Marketplace tuaj yeem txhawb koj lub koom haum lub peev xwm los tsim thiab xa cov ECM thiab Kev Txhawb Nqa Hauv Zej Zog li cas los ntawm kev mus saib nplooj ntawv web PATH TA Marketplace. Thov xa cov lus nug txog txoj cai nkag mus uas tau hloov kho tshiab mus rau ta-marketplace@ca-path.com.
PATH TA Marketplace Round 3 Vendor Application
Thaum Lub Kaum Hli 1, DHCS yuav qhib lub qhov rais thov PATH TA Marketplace Round 3. Lub PATH TA Marketplace yog ib lub khw muag khoom virtual rau cov kev pabcuam TA, ib lub vev xaib ib qho chaw nres tsheb uas cov chaw ua haujlwm tuaj yeem nkag mus rau cov peev txheej TA dawb los ntawm cov neeg muag khoom uas tau xaiv thiab pom zoo los pab txhim kho lawv lub peev xwm los hloov pauv Medi-Cal. Cov koom haum yuav tsum thov kom tsim nyog ua tus muag khoom TA Marketplace ua ntej hnub kawg rau lub Kaum Hli 31. Mus saib nplooj ntawv web ntawm TA Marketplace kom paub ntau ntxiv thiab thov. Yog koj muaj lus nug, thov email rau ta-marketplace@ca-path.com.
Medi-Cal Rx
On September 27 and 28, DHCS delivered the first presentations to update stakeholders on DHCS’ plans to advance Medi-Cal Rx. DHCS presented to the Pharmacy Directors meeting and the California Association of Medical Product Suppliers meeting. Also, on September 22, Reinstatement Phase 4, Lift 2 was successfully implemented. Drug cost ceiling and prior authorization for enteral nutrition and specific standard therapeutic classes for members 22 years of age and older have been reinstated. Additionally, as of September 22, the new COVID-19 vaccines appropriately reimburse the cost of the commercial vaccines (in addition to a $40 incentive fee).
Koom nrog peb pab neeg
DHCS tab tom ntiav rau peb cov nyiaj txiag, tib neeg cov peev txheej, kev cai lij choj, kev tshuaj xyuas, txoj cai tswjfwm kev noj qab haus huv, thiab pab pawg xov xwm thev naus laus zis. Yog xav paub ntxiv, thov mus saib hauv CalCareers lub vev xaib.
DHCS’ purpose is to provide equitable access to quality health care leading to a healthy California for all. DHCS’ goals and objectives reflect DHCS’ tremendous work to transform the state’s health care system and strengthen organizational excellence.
Cov Rooj Sib Tham Cov Neeg Koom Tes thiab Webinar yuav los tom ntej
Consumer-Focused Stakeholder Workgroup (CFSW) Lub Rooj Sib Tham
Thaum Lub Kaum Hli 6, txij 10 txog 11:30 sawv ntxov, DHCS yuav tuav lub rooj sib tham CFSW. Lub hom phiaj ntawm CFSW yog muab sijhawm rau cov neeg koom nrog los tshuaj xyuas thiab muab cov lus taw qhia txog ntau yam ntaub ntawv xa xov ntawm cov neeg siv khoom. Lub rooj sib tham yuav tsom mus rau cov haujlwm ntsig txog kev tsim nyog thiab kev sau npe thiab muab kev sib tham qhib txog cov cai thiab kev ua haujlwm ntawm Medi-Cal. Cov neeg koom nrog CFSW yog cov neeg tawm tswv yim los ntawm lub zej zog tiv thaiv cov neeg siv khoom, cov neeg sawv cev ntawm cov koom haum muab kev pabcuam, thiab cov kws tshaj lij hauv kev kho mob. Thov xa email rau DHCSCFSW@dhcs.ca.gov yog tias koj muaj lus nug. Txhua cov ntaub ntawv sib tham yuav raug tshaj tawm rau ntawm nplooj ntawv web DHCS CFSW tsis pub dhau lub Kaum Hli 4.
CalAIM ICF/DD Carve-In Promising Practices Webinar
On October 6, from 9:30 to 11 a.m., DHCS will virtually host the third in a series of educational webinars (advance registration required) on the California Advancing and Innovating Medi-Cal (CalAIM) intermediate care facility for the developmentally disabled (ICF/DD) carve-in. The goal of these webinars is to provide stakeholders with an understanding of the ICF/DD carve-in policy requirements and how to support members when all Medi-Cal MCPs will be required to cover and coordinate institutional long-term care for members residing in an ICF/DD beginning on January 1, 2024. The webinar will focus on promising practices that MCPs, ICF/DD homes, and Regional Centers can consider as they prepare for the ICF/DD carve-in to take effect. Webinars are open to the public.
Cov ntaub ntawv ntxiv txog cov kev sib tham hauv web uas yuav los txog no muaj nyob rau ntawm nplooj ntawv web hloov pauv CalAIM ICF/DD Long-Term Care Carve-In. Xa email rau cov lus nug lossis cov lus tawm tswv yim rau LTCtransition@dhcs.ca.gov.
Medicare Coverage Choices hauv California: Webinar
On October 11 at 1 p.m., DHCS and the California Department of Aging will jointly host a webinar entitled, “Navigating Medicare Coverage Choices in California, Including Medicare Advantage Supplemental Benefits” (advance registration required). Presenters will include Stephanie Fajuri from the Center for Health Care Rights, an expert in Medicare choices for consumers, and Nils Franco from ATI Advisory, a lead analyst for the review of Medicare Advantage Plan supplemental benefits in California.
Lub webinar yuav qhia cov ntaub ntawv pab tau rau cov neeg siv khoom, tsev neeg, cov kws kho mob, thiab zej zog txoj cai pej xeem. Nws yuav suav nrog kev nthuav qhia thiab kev nug thiab teb cov lus nug txog kev xaiv kev pov hwm Medicare rau cov neeg siv khoom thaum lub sijhawm qhib rau npe nkag Medicare txij lub Kaum Hli 15 txog rau lub Kaum Ob Hlis 7, nrog rau qhia txog phau ntawv qhia DHCS tshiab uas tau tso tawm txog cov txiaj ntsig ntxiv hauv Medicare Advantage Plans hauv California rau xyoo cog lus 2023. Phau ntawv qhia no yog ib feem ntawm cov phau ntawv qhia uas muaj nyob rau ntawm nplooj ntawv web DHCS Office of Medicare Innovation and Integration. Yog koj muaj lus nug los yog lus tawm tswv yim, thov email rau OMII@dhcs.ca.gov.
Stakeholder Advisory Committee (SAC) thiab Behavioral Health-SAC (BH-SAC) Lub Rooj Sib Tham
Thaum Lub Kaum Hli Ntuj hnub tim 19, txij thaum 9:30 sawv ntxov txog 3:30 tsaus ntuj, DHCS yuav tuav lub rooj sib tham sib koom ua ke ntawm SAC thiab BH-SAC tom ntej (yuav tsum tau sau npe ua ntej). Nws yuav qhib ua ib lub rooj sib tham ua ke, nrog rau cov ncauj lus uas SAC thiab BH-SAC sib qhia. Yuav muaj lub rooj sib tham BH-SAC-xwb tom qab lub rooj sib tham ua ke; tsis muaj lub rooj sib tham SAC-xwb. Cov neeg koom nrog tuaj yeem tuaj koom nrog tus kheej ntawm The California Endowment, nyob ntawm 1414 K Street hauv plawv nroog Sacramento, lossis tuaj koom online. Yog xav paub ntxiv, thov mus saib SAC thiab BH-SAC lub vas sab.
Hauv Case Koj Tsis Tau Nws
Medicare Medi-Cal Plans: Cov ntaub ntawv rau cov neeg muaj feem
Thaum lub Cuaj Hlis 22, DHCS tau tshaj tawm cov ntawv qhia txog Medicare Medi-Cal Plans ua lus Askiv, lus Mev, lus Hmoob, lus Nyab Laj, lus Suav/Cantone, lus Lavxias, thiab lus Khmer/Cambodian rau ntawm nplooj ntawv web Medicare Medi-Cal Plan.
The 2024 Medicare open enrollment period is from October 15 to December 7, with plan coverage taking effect on January 1, 2024. Californians in 12 counties will be eligible to enroll in Medicare-Medi-Cal Plans, a type of Medicare Advantage plan in California only available to dual eligible members. Medicare Medi-Cal Plans provide more comprehensive care, and benefits in both programs are coordinated by one managed care plan. In 2024, Medicare Medi-Cal Plans will be available in the following counties: Fresno, Kings, Los Angeles, Madera, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Mateo, Santa Clara, and Tulare. Please contact DHCS with any questions or comments about Medicare Medi-Cal Plans at info@calduals.org.