DHCS Stakeholder News Update – May 6, 2022
Nyob zoo cov neeg muaj feem xyuam,
Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS) tab tom muab qhov hloov tshiab no ntawm kev txhim kho tseem ceeb ntawm DHCS cov kev pabcuam, nrog rau cov lus qhia ntsig txog COVID-19 kev noj qab haus huv rau pej xeem xwm txheej ceev.
DHCS Cov Neeg Ua Haujlwm Hloov Pauv
Thaum Lub Tsib Hlis 31, Kelly Pfeifer, Tus Lwm Thawj Coj Saib Xyuas Kev Noj Qab Haus Huv Kev Noj Qab Haus Huv, yuav so haujlwm los ntawm lub xeev mus ua haujlwm rau lwm yam. Tau ze li ntawm peb lub xyoos, Kelly tau coj txoj kev txhim kho thiab kev siv cov kev hloov pauv, keeb kwm kev mob hlwb thiab kev siv tshuaj yeeb tsis zoo rau cov kev pab cuam thiab cov phiaj xwm, suav nrog hauv California Advancing and Innovating Medi-Cal (CalAIM) teg num, Behavioral Health Continuum Infrastructure Program (BHCIP), thiab Behavioral Health Modernization project.
Tyler Sadwith, Tus Pab Lwm Tus Thawj Coj rau Kev Noj Qab Haus Huv Tus Cwj Pwm, yuav ua tus Lwm Tus Thawj Coj Ua Haujlwm thaum Kelly tawm haujlwm.
BHCIP thiab Community Care Expansion Program Update
Xyoo 2021-22 California State Budget tau muab kev nqis peev ib zaug hauv ib tiam neeg rau kev pab nyiaj txiag rau kev tsim kho vaj tse nrog rau cov peev txheej tshiab tseem ceeb ntawm lub xeev thiab tsoomfwv los daws teeb meem kev tsis muaj tsev nyob, txhawb kev hloov pauv kev kho mob, thiab txhawb nqa kev nyab xeeb hauv zej zog. Ua ke cov lus cog tseg no yuav daws cov teeb meem keeb kwm yav dhau los hauv kev noj qab haus huv ntawm tus cwj pwm kom tau raws li qhov xav tau ntawm cov kev pabcuam thiab kev txhawb nqa. Cov peev txheej tsim kho vaj tse, coj los ntawm DHCS thiab California Department of Social Services, yuav ua kom ntseeg tau tias kev saib xyuas tuaj yeem muab tau rau hauv qhov chaw tsawg tshaj plaws los ntawm kev tsim ntau yam kev xaiv, suav nrog cov kev xaiv rau cov neeg mob sab nraud, kev saib xyuas sai, kev so nrog cov phooj ywg, cov chaw noj qab haus huv, cov qauv kev kho kom rov zoo hauv zej zog, thiab cov chaw saib xyuas hauv zej zog uas tau tso cai. Ntau qhov chaw saib xyuas neeg mob tuaj yeem muab kev pabcuam tseem ceeb los ntawm kev pabcuam kev noj qab haus huv thiab hloov cov neeg California uas tsis muaj zog tshaj plaws mus rau hauv zej zog, thiab muab cov kev xaiv vaj tse rau cov neeg laus thiab cov neeg xiam oob qhab. Yog xav paub ntxiv txog cov kev pab cuam no, thov mus saib nplooj ntawv web BHCIP.
Medi-Cal Rx 180-Hnub Txoj Cai Hloov Hloov
When Medi-Cal Rx launched, a 180-day transition policy was implemented to reduce the impact of the transition on Medi-Cal beneficiaries by extending their previously approved prescriptions, with or without previously approved prior authorizations (PA), through July 1, 2022. Medi-Cal Rx will continue to use historical PA and claims data for the transition policy beyond July 1, 2022. DHCS and Magellan Medicaid Administration are evaluating the appropriate time to terminate this transition policy. Detailed information will be provided in the coming weeks. Stakeholders will be given 90 days’ notice prior to the end of the 180-day transition policy.
Population Health Management (PHM) Vendor Contract
On May 9, DHCS will release an Invitation for Proposal (IFP) for a PHM Service vendor, as part of the CalAIM initiative. DHCS intends to award the resulting contract by July 2022. This procurement solicits applications for the development, operation, and eventual turnover to DHCS of the PHM Service.
PHM Kev Pabcuam nrhiav kev hloov pauv tag nrho-tus neeg muab kev saib xyuas rau cov neeg tau txais txiaj ntsig Medi-Cal, thaum tswj hwm kev pheej hmoo thiab daws qhov tsis sib xws hauv kev saib xyuas thiab kev noj qab haus huv ntawm cov neeg tsav tsheb. Qhov Kev Pabcuam PHM yuav txhawb nqa cov neeg tau txais txiaj ntsig-kev pom zoo rau cov neeg koom tes ua lag luam (lub xeev cov tuam haujlwm thiab cov koom haum, cov koom tes hauv nroog, thiab lwm yam); cov koom tes hauv kev saib xyuas kev noj qab haus huv (tsev kho mob, chaw tu neeg mob, thiab lwm yam); thiab cov koom haum saib xyuas kev tswj hwm (county Drug Medi-Cal, Medicare Advantage, thiab lwm yam) nrog rau kev nkag mus rau cov ntaub ntawv kho mob thiab kev pab cuam uas tuaj yeem siv los pab txhim kho kev saib xyuas zoo.
DHCS xav tias kev siv PHM Service yuav pab txhawb rau lub hom phiaj CalAIM tag nrho ntawm kev txhim kho lub neej zoo thiab kev noj qab haus huv ntawm cov neeg tau txais txiaj ntsig, ua raws li Medi-Cal cov kev pib uas tau teev tseg hauv Assembly Bill 133 (Tshooj 143, Statutes of 2021). Muaj cov ntaub ntawv ntxiv txog PHM Service nyob rau hauv daim ntawv qauv PHM Program thiab Service Roadmap. Yog koj muaj lus nug lossis lus tawm tswv yim, thov xa email rau CalAIM@dhcs.ca.gov.