DHCS Stakeholder Updates – July 1, 2022
Dear Stakeholders,
The Department of Health Care Services (DHCS) is providing this update of significant developments regarding DHCS programs.
Kev muab khoom plig ntawm Dental Contract
On July 1, 2022, DHCS issued a Notice of Intent to Award for the Fiscal Intermediary-Dental Business Operations (FI-DBO) contract, which will provide services to support California’s Medi-Cal fee-for-service dental benefit. Following a competitive procurement process, the successful bidder is Gainwell Technologies LLC.
Over the next year, the incumbent vendor, Delta Dental of California, will transition operations to the new vendor, Gainwell. The anticipated date for Gainwell to assume responsibility for dental business operations is October 1, 2023. DHCS’ goal is for this transition to be seamless for Medi-Cal members and providers, with no reduction in or delay of services.
Daim Ntawv Pom Zoo 56 Qhov Kev Pab Them Rov Qab Los - CalHealthCares
DHCS announced its commitment to pay $64.9 million toward student loans for 222 physicians and 35 dentists under CalHealthCares to expand access to care for Medi-Cal patients under a fourth cohort of awardees. Of the 257 awardees, 62 percent are persons of color, and 79 percent speak a language other than English. The physicians represent 67 specialties and serve 33 counties. The dentists represent four specialties and serve 19 counties. The awardees have agreed to maintain a caseload of at least 30 percent Medi-Cal patients, with more than 57 percent of awardees committing to maintaining a caseload of 65 percent or higher. A fifth cohort is scheduled for 2023. For more information, visit the CalHealthCares website.
Txhim Kho Kev Tswj Xyuas Kev Kho Mob (ECM) thiab Zej Zog Txhawb Kev Pabcuam Hloov Kho
Pib txij Lub Xya Hli 1, cov txiaj ntsig ECM muaj nyob hauv txhua lub nroog California rau cov tswv cuab tsim nyog Medi-Cal tswj hwm txoj kev npaj kho mob (MCP) rau cov pej xeem hauv qab no ntawm kev tsom xam: cov tib neeg thiab cov tsev neeg ntsib kev tsis muaj tsev nyob, cov neeg siv nyiaj siab, thiab cov neeg laus uas muaj mob hlwb loj (SMI) / kev siv tshuaj yeeb (SUD). Lub nroog tshiab siv ECM txij thaum Lub Xya Hli 1 suav nrog Alpine, Amador, Butte, Calaveras, Colusa, Del Norte, El Dorado, Fresno, Glenn, Humboldt, Inyo, Lake, Lassen, Madera, Mariposa, Merced, Modoc, Mono, Nevada, Plumas, San Benito, San Luis Sibara, you Stanislaus, Sutter, Tehama, Trinity, Tuolumne, Yolo, thiab Yuba.
Tsis tas li ntawd, txij thaum Lub Xya Hli 1, MCPs tab tom siv 266 Kev Txhawb Zej Zog ntxiv, nthuav dav kev pabcuam rau cov khoom tshwj xeeb no rau tag nrho 58 lub nroog California. Cov kev pabcuam tseem ceeb nthuav dav suav nrog cov kev pabcuam hauv zej zog ntsig txog zej zog, nrog rau MCPs qhia 35 qhov kev pabcuam kev hloov pauv vaj tsev tshiab, 44 qhov kev tso vaj tsev tshiab, thiab 36 qhov kev pabcuam vaj tsev tshiab thiab kev txhawb nqa, nrog rau cov kev pabcuam so (34 qhov tshiab) thiab kev saib xyuas tus kheej thiab kev pabcuam hauv tsev (31 qhov kev pabcuam tshiab). Nrog 518 Cov Kev Pabcuam Hauv Zej Zog twb muaj lawm txij li thaum pib qhov kev pab cuam thaum Lub Ib Hlis 1, tam sim no muaj 784 Cov Kev Pab Txhawb Zej Zog sib txawv muaj nyob thoob plaws 58 lub nroog hauv California. DHCS tau tsim ib daim ntawv qhia kev txhawb nqa zej zog uas muaj rau pej xeem uas qhia tus naj npawb ntawm 14 qhov kev pom zoo ua ntej Kev Txhawb Zej Zog yuav nyob rau xyoo 2022 los ntawm lub nroog thiab hnub ua haujlwm. Ib Daim Ntawv Txhawb Kev Txhawb Zej Zog kuj muaj, nthuav dav uas muaj nyob rau hauv txhua MCP hauv txhua lub nroog thiab kwv yees cov kev pabcuam yav tom ntej.
Community Health Worker (CHW) tau txais txiaj ntsig
On July 1, the CHW benefit went live in both the Medi-Cal fee-for-service (FFS) and managed care delivery systems. The State Plan Amendment (SPA) for CHWs was submitted to the Centers for Medicare & Medicaid Services (CMS) on April 29, 2022, and is pending approval. DHCS published the final CHW policy on June 29 to assist providers with rolling out this new benefit. DHCS shared a draft of the Provider Manual pages for CHW services, as well as a new Provider Manual section for asthma preventive services, with stakeholders prior to finalizing them for publication. The Provider Manual pages are scheduled to be published on July 15. In addition, DHCS shared a draft All Plan Letter (APL) for CHW services with its managed care health plan partners on June 28 for comments prior to issuing the APL. Comments on the APL are due by July 12. More information about the Department’s development of the CHW benefit, including the pending SPA that was submitted to CMS, is available on CHW webpage.