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
On September 29, DHCS released a revised version of the 2024 MCP Transition Policy Guide that includes DHCS policy and MCP requirements related to member transitions of Medi-Cal MCPs that take effect on January 1, 2024. The latest version includes a new MCP transition monitoring and oversight policy and transition-related requirements for incentive programs, as well as updates to all other sections. The policy guide will be updated regularly to keep MCPs informed of new and developing guidance.
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
On September 29, DHCS announced the revised policy for accessing free TA resources available through the PATH TA Marketplace. Effective immediately, all approved TA recipients may now access both off-the-shelf TA projects and hands-on TA projects in all seven TA domains, regardless of if they are contracted with a MCP or other eligible entity to provide Enhanced Care Management (ECM) and/or Community Supports. Learn how free TA services offered through the PATH TA Marketplace can strengthen your organization’s ability to build and deliver quality ECM and Community Supports by visiting the PATH TA Marketplace webpage. Please submit any questions regarding the revised access policy to ta-marketplace@ca-path.com.
PATH TA Marketplace Round 3 Vendor Application
On October 1, DHCS will open the PATH TA Marketplace Round 3 vendor application window. The PATH TA Marketplace is a virtual marketplace for TA services, a one-stop-shop website where entities can access free TA resources from curated and approved vendors to help build their capacity to transform Medi-Cal. Organizations must apply to qualify as a TA Marketplace vendor before the October 31 deadline. Visit the TA Marketplace vendor webpage for more information and to apply. For questions, please email 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.
The webinar will share helpful information for consumers, families, health care providers, and the public policy community. It will include a presentation and question and answer session on Medicare coverage choices for consumers during the Medicare Open Enrollment period from October 15 to December 7, as well as highlight a newly released DHCS chartbook on supplemental benefits in Medicare Advantage Plans in California for contract year 2023. The chartbook is part of a series of chartbooks available on the DHCS Office of Medicare Innovation and Integration webpage. For questions or comments, please email OMII@dhcs.ca.gov.
Stakeholder Advisory Committee (SAC) thiab Behavioral Health-SAC (BH-SAC) Lub Rooj Sib Tham
On October 19, from 9:30 a.m. to 3:30 p.m., DHCS will host the next SAC and BH-SAC hybrid meeting (advance registration required). It will open as a joint meeting, with topics shared by SAC and BH-SAC. A BH-SAC-only meeting will be held after the joint meeting; there is no SAC-only meeting. Participants may attend in person at The California Endowment, located at 1414 K Street in downtown Sacramento, or virtually. For more information, please visit the SAC and BH-SAC webpages.
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.