January 26, 2024 – Stakeholder News
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
In early February, DHCS will refresh messaging for the Medi-Cal renewal campaign. New ads will prepare people for the return of annual Medi-Cal renewals. The ads will run on digital, television, radio, print, and out-of-home platforms. The content will be distributed through existing partnerships with Univision and Telemundo for Spanish-language television and a new partnership with CrossingsTV for Mandarin, Cantonese, Vietnamese, Punjabi, Korean, and Hmong programming. Select videos will also be updated to include voiceovers to increase accessibility and exposure to more audiences, such as the visually impaired and those who cannot read. Voiceover videos will be available in all threshold languages. New awareness and renewal outreach materials will be available on the Keep Your Community Covered resources hub for download and sharing in all 19 threshold languages.
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 is accepting feedback and public comment until February 7 at 5 p.m. Feedback and questions can be submitted to DHCS.SBS@dhcs.ca.gov. For more information, please visit the CYBHI webpage.
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:
- Chief of Capitated Rates Development Division within Health Care Financing to serve as the principal policymaker for all rate-setting activities to ensure high-quality and cost-efficient health care through DHCS’ contracted Medi-Cal MCPs. (Final filing date is January 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 is seeking approval from the Centers for Medicare & Medicaid Services (CMS) to include expenditure authority under Section 1115(a)(2) to receive federal matching funds to provide continuous coverage for children through the end of the month in which their 5th birthday falls, regardless of when they first enroll in Medi-Cal or the Children’s Health Insurance Program and any changes in circumstances that would otherwise cause a loss of eligibility. Implementation of this policy is contingent upon a state determination of available General Fund resources in 2024-2025 and subsequent fiscal years and CMS approval. Additional information is available on the DHCS CalAIM 1115 Demonstration and 1915(b) Waiver webpage.
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
On January 1, DHCS achieved a significant milestone in its transformation of Medi-Cal with the launch of the new managed care contract and the MCP transition, under which approximately 1.2 million members gained new health plan options and/or transitioned to new MCPs (note: changing MCPs does not affect Medi-Cal member coverage or benefits). To facilitate a smooth transition between MCPs for members, DHCS created Continuity of Care protections to minimize disruptions to members’ care.
DHCS developed several resources to support members, providers, and other stakeholders with the transition, including the MCP Transition Member webpage with a county “lookup” tool, links to the member notices sent by Medi-Cal about MCP changes, member frequently asked questions in all threshold languages, and a Contact Us page for members to learn more about health plan changes. There are also transition resources for providers, MCPs, and stakeholders. More information about the transition is available in the 2024 MCP Transition Policy Guide and Medi-Cal Eligibility Division Information Letter Number 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.