Kev hloov kho tshiab

Hloov Kho Kev Tswj Xyuas Kev Kho Mob (ECM) thiab Cov Ntaub Ntawv Txhawb Zej Zog

Thaum Lub Ib Hlis 29, DHCS yuav tshaj tawm cov ntaub ntawv ECM thiab Kev Txhawb Zej Zog tshiab los ntawm Medi-Cal cov phiaj xwm tswj hwm kev saib xyuas (MCPs). Daim ntawv tshaj tawm tshiab muab cov ntawv tshaj tawm sib tham sib kho tshiab uas txhim kho daim ntawv qhia txog kev siv xyoo 2022 los ntawm kev muab cov ntaub ntawv ntxaws hauv xeev-, nroog-, thiab MCP-theem mus txog lub quarter 2 2023. Qhov hloov tshiab peb lub hlis twg tom ntej, uas yuav suav nrog cov ntaub ntawv siv rau lub quarter 3 2023, tau npaj rau kev tso tawm thaum kawg ntawm Lub Peb Hlis 1 2024.

Medi-Cal Renewal Campaign Refresh

Thaum pib lub Ob Hlis, DHCS yuav rov ua cov lus tshiab rau kev sib tw txuas ntxiv Medi-Cal. Cov kev tshaj tawm tshiab yuav npaj cov neeg rau kev rov qab los ntawm kev txuas ntxiv Medi-Cal txhua xyoo. Cov tshaj tawm yuav khiav ntawm digital, TV, xov tooj cua, luam tawm, thiab cov platform sab nraum tsev. Cov ntsiab lus yuav raug faib tawm los ntawm kev koom tes uas twb muaj lawm nrog Univision thiab Telemundo rau kev tshaj tawm hauv TV lus Mev thiab kev koom tes tshiab nrog CrossingsTV rau kev tshaj tawm lus Mandarin, Cantonese, Nyab Laj, Punjabi, Kauslim, thiab Hmoob. Cov yeeb yaj kiab xaiv kuj tseem yuav raug hloov kho kom suav nrog cov lus hais kom ua rau muaj kev nkag tau yooj yim thiab kev nthuav dav rau ntau tus neeg tuaj saib, xws li cov neeg tsis pom kev zoo thiab cov neeg uas nyeem tsis tau ntawv. Cov yeeb yaj kiab hais lus yuav muaj nyob rau hauv txhua hom lus. Cov ntaub ntawv tshiab txog kev paub thiab kev txuas lus tshiab yuav muaj nyob rau ntawm lub chaw khaws cov peev txheej Keep Your Community Covered rau rub tawm thiab sib qhia ua txhua 19 hom lus.

DHCS tseem tab tom siv cov ntaub ntawv muaj nyob rau hauv retarget cov zej zog uas muaj tus nqi rov qab qis dua, tshwj xeeb nrog cov nqi siab ntawm kev rho npe vim cov tswv cuab tsis muab cov ntaub ntawv thov lossis cov ntaub ntawv.

Children and Youth Behavioral Health Initiative (CYBHI) Daim Ntawv Qhia Tus Nqi

Thaum Lub Ib Hlis 25, DHCS tau tshaj tawm tsab ntawv qhia txog tus nqi CYBHI rau pej xeem tawm tswv yim. Daim ntawv qhia kev taw qhia qhia txog cov cai thiab cov txheej txheem ua ntej kom nthuav dav kev nkag mus rau tsev kawm ntawv-txuas kev pabcuam kev coj cwj pwm kev noj qab haus huv los ntawm lub xeev cov neeg them nyiaj ntau lub tsev kawm ntawv txuas nrog lub sijhawm (CYBHI tus nqi teem sijhawm) thiab suav nrog cov lus qhia rau Lub Chaw Haujlwm Saib Xyuas Kev Kawm Hauv Zos, cov kws kho mob, Medi-Cal MCPs, thiab lwm tus neeg tuav pov hwm.

DHCS txais cov lus taw qhia thiab cov lus tawm tswv yim rau pej xeem txog rau lub Ob Hlis 7 thaum 5 teev tsaus ntuj. Cov lus taw qhia thiab cov lus nug tuaj yeem xa mus rau DHCS.SBS@dhcs.ca.gov. Yog xav paub ntxiv, thov mus saib CYBHI lub vev xaib.

Comprehensive Perinatal Services Program (CPSP) Services Billing Expansion

Thaum Lub Ob Hlis 1, DHCS yuav siv cov kev hloov pauv uas tsim nyog los tso cai rau cov niam tsev yug menyuam uas tau tso npe ua CPSP cov kws kho mob nrog California Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (CDPH) los sau nqi rau CPSP cov kev pabcuam muab rau Medi-Cal tus nqi-rau-kev pabcuam (FFS) cov tswvcuab. Yog tias koj muaj lus nug txog kev tso npe rau CPSP los ntawm CDPH, thov xa email rau CPSPProviderEnrollment@cdph.ca.gov.

Koom nrog peb pab neeg

DHCS tab tom ntiav:

• Tus Thawj Coj ntawm Pawg Neeg Tsim Kho Tus Nqi Capitated hauv Kev Pab Nyiaj Txiag Kev Kho Mob los ua tus tsim cai tseem ceeb rau txhua yam kev ua ub no teem tus nqi kom ntseeg tau tias kev kho mob zoo thiab siv nyiaj tau zoo los ntawm DHCS cov Medi-Cal MCPs uas tau cog lus. (Hnub kawg rau kev xa daim ntawv thov yog Lub Ib Hlis 30)

DHCS is also hiring for our communications, human resources, auditing, health policy, information technology, and other teams. For more information, please visit the CalCareers website.

Cov Rooj Sib Tham Cov Neeg Koom Tes thiab Webinar yuav los tom ntej

Pejxeem Lub Rooj Sib Hais: Kev Pab Cuam Ntxiv rau Cov Menyuam Hloov Kho rau CalAIM Kev Ua Haujlwm

Thaum Lub Ib Hlis Ntuj Tim 29, thaum 1 txog 2 teev tsaus ntuj, DHCS yuav tuav lub rooj sib hais rau pej xeem (yuav tsum tau sau npe ua ntej) los nug cov neeg koom nrog cov lus hais txog qhov kev thov hloov kho rau California Advancing and Innovating Medi-Cal (CalAIM) Tshooj 1115 ua qauv qhia ntsig txog kev pab them nqi tas mus li rau cov menyuam yaus.

DHCS tab tom nrhiav kev pom zoo los ntawm Lub Chaw rau Medicare & Medicaid Services (CMS) kom suav nrog txoj cai siv nyiaj raws li Tshooj 1115 (a) (2) kom tau txais cov nyiaj sib phim los ntawm tsoomfwv los muab kev pab them nqi rau cov menyuam yaus mus txog thaum kawg ntawm lub hlis uas lawv hnub yug 5 xyoos, tsis hais thaum twg lawv thawj zaug rau npe hauv Medi-Cal lossis Children's Health Insurance Program thiab txhua qhov kev hloov pauv hauv cov xwm txheej uas yuav ua rau poob qhov tsim nyog. Kev siv txoj cai no yog nyob ntawm seb lub xeev txiav txim siab txog cov peev txheej ntawm General Fund uas muaj nyob rau xyoo 2024-2025 thiab cov xyoo nyiaj txiag tom ntej thiab CMS kev pom zoo. Cov ntaub ntawv ntxiv muaj nyob rau ntawm nplooj ntawv web DHCS CalAIM 1115 Demonstration thiab 1915(b) Waiver.

Doula Stakeholder Implementation Workgroup Meeting

Thaum Lub Ib Hlis 31, txij thaum 2 txog 4 teev tsaus ntuj, DHCS yuav tuav lub rooj sib tham Doula Stakeholder Implementation Workgroup los tshuaj xyuas qhov kev siv ntawm Medi-Cal doula cov txiaj ntsig, raws li Senate Bill 65 (Tshooj 449, Statutes of 2021) thiab tshooj 14132.24 ntawm Txoj Cai Lij Choj thiab Lub Tsev Haujlwm.

The meeting will be held via Zoom, with an in-person option at 1700 K Street, Room 1014, Sacramento, CA 95811. The meeting is open to the public. The link to attend the meeting virtually and the agenda are posted on the Doula Services as a Medi-Cal Benefit webpage. The workgroup will discuss how to ensure doula services are available to Medi-Cal members and make recommendations on outreach efforts. Please email DoulaBenefit@dhcs.ca.gov with any questions.

Consumer-Focused Stakeholder Workgroup (CFSW) Virtual Meeting

On February 2, beginning at 10 a.m., DHCS will hold the next CFSW meeting. The agenda, meeting materials, and instructions on how to join the meeting will be posted on the DHCS CFSW webpage by noon on January 31.

ECM rau Birth Equity Populations Webinar

Thaum Lub Ob Hlis 2, thaum 1:30 txog 3 teev tsaus ntuj, DHCS yuav tuav lub vev xaib ntawm Kev Tshaj Tawm ECM rau Cov Neeg Yug Me Nyuam (yuav tsum tau sau npe ua ntej) los tshuaj xyuas lub zeem muag ntawm ECM rau cov neeg yug me nyuam ntawm kev tsom xam (POF), nrog rau cov hnub pib ntawm kev siv. DHCS, koom tes nrog Medi-Cal MCPs thiab cov chaw muab kev pabcuam thoob plaws lub xeev, tau pib ECM rau kev sib npaug POF thaum Lub Ib Hlis 1. Qhov webinar no yuav muab cov ntsiab lus ntawm kev tsim thiab kev taw qhia kev ua haujlwm rau kev yug me nyuam POF; muab kev pom zoo rau tus kws kho mob txog seb lawv tau npaj li cas rau kev tshaj tawm ECM rau kev yug me nyuam POF thiab cov txheej txheem tsim los muab ECM; thiab muab kev taw qhia rau MCPs, cov nroog, thiab cov chaw muab kev cog lus thiab npaj xa cov txiaj ntsig ECM los daws qhov tsis sib xws hauv kev noj qab haus huv thiab kev yug me nyuam hauv cov haiv neeg thiab haiv neeg uas muaj leej niam muaj mob hnyav thiab cov neeg tuag coob.  

Lub webinar yog qhib rau txhua tus, tab sis yuav muaj kev txaus siab tshwj xeeb rau MCPs thiab cov chaw zov me nyuam ua haujlwm nrog cov neeg yug me nyuam, suav nrog cov nroog thiab cov koom haum hauv zej zog. Cov kws kho mob xav paub ntau ntxiv txog ECM rau kev sib npaug ntawm kev yug me nyuam POF lossis hais txog cov tswv cuab tuaj yeem tuaj koom. Cov neeg koom nrog raug caw kom xa cov lus nug ua ntej Lub Ib Hlis 29 mus rau CalAIMECMILOS@dhcs.ca.gov. Cov neeg tuaj koom yuav tuaj yeem nug cov lus nug thaum lub webinar. 

Hearing Aid Coverage for Children Program (HACCP) Webinar rau Cov Kws Kho Mob thiab Cov Kws Kho Hniav

On February 13, from 12 to 1 p.m., DHCS will host a HACCP webinar (advance registration required) to share information with providers to help pediatric patients and their families maximize HACCP benefits. The training session will outline program requirements for families to apply for coverage. It will also outline the claims submission process for audiologists, otolaryngologists, physicians, and their office staff. For more information, please visit www.dhcs.ca.gov/haccp.

Hauv Case Koj Tsis Tau Nws

Medi-Cal Targeted Rate nce (TRI)

Pursuant to Assembly Bill (AB) 118 (Chapter 42, Statutes of 2023), DHCS published, as part of the proposed 2024–25 Governor’s Budget, a plan for targeted increases to Medi-Cal payments or other investments, effective in 2025, across primary care, maternal care, behavioral health care, specialty care, women’s health services, public hospital services, community and hospital outpatient services, emergency services, and other domains. The proposed investments will be supported with funding from the Managed Care Organization (MCO) Tax, authorized by AB 119 (Chapter 13 , Statutes of 2023), and are designed to advance access, quality, and equity for Medi-Cal members and promote provider participation in the Medi-Cal program. These proposed investments are subject to obtaining all necessary legislative and federal approvals, as applicable. For more information, please visit the Medi-Cal Targeted Provider Rate Increases and Investments webpage and view the Medi-Cal TRI policy paper and MCO Tax-funded investments.

Kev Pabcuam Nruam Unwinding Cov Ntaub Ntawv 90-Hnub Hloov Kho Tshiab

Thaum Lub Kaum Ob Hlis 29, DHCS tau xa mus rau CMS qhov kev hloov kho tshiab rau tsoomfwv cov ntaub ntawv tshaj tawm rau lub Rau Hli mus txog Lub Yim Hli 2023. Cov tib neeg uas raug txiav tawm los ntawm Medi-Cal vim cov txheej txheem txheej txheem muaj 90 hnub los xa cov ntaub ntawv tsim nyog rau cov nroog kom ua tiav lawv qhov kev rov ua dua tshiab. Raws li lub sijhawm xav tau los xa cov ntaub ntawv tsis txaus ntseeg, cov ntawv xa tawm yav dhau los tsis suav nrog cov tib neeg uas tau txais lawv cov Medi-Cal rov qab los rau lub sijhawm 90-hnub rov xav dua. Qhov kev hloov tshiab no suav nrog kev hloov tshiab ntawm cov ntaub ntawv xa tawm yav dhau los, suav nrog cov txiaj ntsig rau cov tib neeg hauv 90-hnub rov xav txog lub sijhawm.

The updated data is accessible on the Medi-Cal Enrollment and Renewal Data webpage under the “Medi-Cal Continuous Coverage Unwinding Dashboards” section. Additionally, the California Health & Human Services Agency posted on its Medium page a piece by DHCS Director Michelle Baass about the 90-day data refresh.

Lub Ib Hlis 2024 Medi-Cal MCP Kev Hloov Pauv

Thaum Lub Ib Hlis 1, DHCS tau ua tiav ib qho tseem ceeb hauv nws txoj kev hloov pauv ntawm Medi-Cal nrog kev tshaj tawm daim ntawv cog lus tshiab ntawm kev tswj hwm kev saib xyuas thiab kev hloov pauv MCP, uas kwv yees li 1.2 lab tus tswv cuab tau txais cov kev xaiv phiaj xwm kho mob tshiab thiab / lossis hloov mus rau MCPs tshiab (ceeb toom: kev hloov MCPs tsis cuam tshuam rau kev them nqi lossis cov txiaj ntsig ntawm Medi-Cal cov tswv cuab). Yuav kom yooj yim rau kev hloov pauv ntawm MCPs rau cov tswv cuab, DHCS tau tsim cov kev tiv thaiv Kev Saib Xyuas Txuas Ntxiv mus kom txo qis kev cuam tshuam rau kev saib xyuas cov tswv cuab.

DHCS tau tsim ntau yam kev pab los txhawb cov tswv cuab, cov neeg muab kev pab, thiab lwm cov neeg koom nrog kev hloov pauv, suav nrog nplooj ntawv web MCP Transition Member nrog lub cuab yeej "nrhiav" ntawm lub nroog, cov kev sib txuas mus rau cov ntawv ceeb toom ntawm cov tswv cuab uas Medi-Cal xa txog kev hloov pauv MCP, cov lus nug nquag nug ntawm cov tswv cuab hauv txhua hom lus, thiab nplooj ntawv Tiv Tauj Peb rau cov tswv cuab kom paub ntau ntxiv txog kev hloov pauv ntawm txoj kev npaj kho mob. Kuj tseem muaj cov peev txheej hloov pauv rau cov neeg muab kev pabcuam, MCPs, thiab cov neeg koom nrog. Muaj cov ntaub ntawv ntxiv txog kev hloov pauv no nyob rau hauv Phau Ntawv Qhia Txoj Cai Hloov Pauv ntawm MCP xyoo 2024 thiab Tsab Ntawv Qhia Txog Kev Tsim Nyog ntawm Medi-Cal Tus lej I 23-54.

The MCP Transition Member webpage includes resources and information to support members’ transition. Members unable to resolve issues or questions after working with their MCP may contact DHCS’ Office of the Ombudsman at toll-free (888) 452-8609 or by emailing MMCDOmbudsmanOffice@dhcs.ca.gov.