Peb Hlis 24, 2025
Xov xwm tshaj plaws
Kalifonias xa daim ntawv thov kom nthuav dav kev kho kab mob Sickle Cell
On March 11, DHCS applied to CMS to participate in the groundbreaking Cell and Gene Therapy (CGT) Access Model. If accepted, DHCS will implement this multi-year initiative to expand Medi-Cal members’ access to innovative and potentially life-changing therapies for sickle cell disease (SCD), a severe genetic blood disorder that disproportionately impacts people of African descent. Gene therapy represents a groundbreaking approach to SCD. However, these therapies come with extraordinary costs, making access difficult for patients and Medicaid programs, including Medi-Cal. The CGT Access Model addresses this challenge by using a negotiated rebate system that ties payments for these treatments to patient outcomes. If the therapy does not meet expected health improvements, drug manufacturers will provide rebates to Medicaid programs, helping ensure financial sustainability while expanding access to care. If California is approved, eligible Medi-Cal members would gain access to gene therapy treatment, fertility preservation services, case management, travel assistance, and behavioral health support. CMS anticipates testing the model over an 11-year performance period. If approved, California will begin participating in this model on July 1, 2025.
Txoj Kev Kho Mob Ncauj Ncauj Qhia Kev Ua Haujlwm Pabcuam
On March 21, DHCS published Behavioral Health Information Notice (BHIN) 25-007 – Traditional Health Care Practices Benefit Implementation. This policy, the result of years of dedicated effort and advocacy from California Tribal leaders and partners, provides guidance on the implementation of the traditional health care practices benefit in the Drug Med-Cal Organized Delivery System (DMC-ODS). The federal Centers for Medicare & Medicaid Services (CMS) approved DHCS to cover traditional health care practices provided by Indian Health Care Providers (IHCP) for Medi-Cal members in DMC-ODS counties through December 31, 2026, unless extended or amended. Traditional health care practices encompass two new service types: Traditional Healer and Natural Helper services. DMC-ODS counties will cover Traditional Healer and Natural Helper services provided by IHCPs to Medi-Cal members who meet DMC-ODS access criteria. For questions about traditional health care practices or this BHIN, please email traditionalhealing@dhcs.ca.gov.
Additionally, on April 22, DHCS will present an overview of BHIN 25-007 at the Tribes and Indian Health Program Representatives meeting (advance registration required). The presentation is open to the public and will review policy guidance to support IHCPs and DMC-ODS counties in implementing this new benefit. Attendees are encouraged to submit questions in advance to traditionalhealing@dhcs.ca.gov with the subject line “Traditional Health Care Practices Implementation.”
Kev hloov kho tshiab
Tam sim no muaj: Cov ntaub ntawv Webinar ntawm Kaw-Loop xa mus rau kev coj ua
Effective July 1, 2025, Medi-Cal managed care plans will be required to implement Closed-Loop Referral (CLR) requirements for Enhanced Care Management (ECM) and Community Supports. CLR requirements aim to increase the number of Medi-Cal members successfully connected to these benefits and services. By improving information collection processes, managed care plans will be able to better support individual referrals and address system-level gaps in referral practices and service availability that impact members. DHCS released materials from the February 13 webinar (posted under Informational Webinars) to share more details about these requirements. In the webinar, DHCS provided:
- The Department’s goal and motivation for releasing new CLR requirements.
- Yuav ua li cas CLR cov cai yuav txhim kho cov txheej txheem xa mus rau cov tswv cuab los ntawm kev txhim kho kev xa mus taug qab, txhawb nqa, thiab saib xyuas kev siv zog.
- Ib qho piv txwv ntawm kev siv cov xwm txheej hais txog yuav ua li cas CLR cov cai yuav pab tau ib tus tswv cuab kom tau txais Kev Pabcuam Khomob Khomob Hauv Zej Zog.
Hu rau DHCS nrog rau cov lus nug lossis lus hais txog California Advancing and Innovating Medi-Cal (CalAIM) Population Health Management initiatives ntawm PHMSection@dhcs.ca.gov.
Koom nrog peb pab neeg
DHCS tab tom ntiav rau nws cov nyiaj txiag, tib neeg cov peev txheej, khw muag tshuaj, kev noj qab haus huv, thiab lwm pab pawg. Yog xav paub ntxiv, thov mus saib hauv CalCareers lub vev xaib.
Cov Rooj Sib Tham Cov Neeg Koom Tes thiab Webinar yuav los tom ntej
DHCS tshaj tawm cov rooj sib tham pej xeem yav tom ntej ntawm Daim Ntawv Teev Npe ntawm Cov Txheej Txheem.
Kev Pabcuam Ambassador Webinar
Thaum Lub Peb Hlis 25, thaum 11 teev sawv ntxov txog 12 teev tsaus ntuj PDT, DHCS yuav tuav ib qho Kev Pab Cuam Tshaj Tawm Webinar (yuav tsum tau sau npe ua ntej) los muab cov ntaub ntawv hais txog kev xaiv kho mob thiab hloov tshiab rau Medi-Cal. Coverage Ambassadors pab tshaj tawm cov lus hais txog cov txiaj ntsig ntawm Medi-Cal, cov ntaub ntawv sau npe, thiab cov haujlwm tshiab tsom rau kev tsim kom muaj kev noj qab haus huv California rau txhua tus. Thov mus saib hauv Coverage Ambassador lub vev xaib kom paub ntau ntxiv, lossis sau npe ua tus Coverage Ambassador thiab tau txais kev hloov tshiab tsis tu ncua.
Tswj Kev Pabcuam Sijhawm Ntev thiab Kev Txhawb Nqa (MLTSS) thiab Duals Integration Workgroup lub rooj sib tham
On March 27, from 10 a.m. to 12 p.m. PDT, DHCS will host the CalAIM MLTSS and Duals Integration Workgroup meeting (advance registration required). The workgroup is a stakeholder collaboration hub for CalAIM MLTSS and integrated care for dual eligible members. It allows stakeholders to provide feedback and share information about policy, operations, and strategy for upcoming changes to Medi-Cal and Medicare. The meeting agenda includes updates on Medicare enrollment data for dual eligible members, the Dual Eligible Special Needs Plan (D-SNP) Dashboard, D-SNP initiatives, and the D-SNP State Medicaid Agency Contract and Policy Guide. It also includes data updates on Enhanced Care Management and Community Supports for dual eligibles and a Community Supports service spotlight presentation on select service definition updates.
More information, background materials, transcripts, and video recordings of previous workgroup meetings are posted on the CalAIM MLTSS and Duals Integration Workgroup webpage. For questions or comments, please email DHCS at info@calduals.org.
Hearing Aid Coverage for Children Program (HACCP) Webinar rau Cov Kws Kho Mob thiab Cov Kws Kho Hniav
On March 27, from 12 to 1 p.m. PDT, DHCS will host the quarterly HACCP webinar for medical providers and hearing professionals. For more information and to register, please visit DHCS’ HACCP webpage. Registration information will be posted as the webinar date approaches.
Hauv Case Koj Tsis Tau Nws
Tam sim no Qhib: Muab Kev Nkag Mus Nkag thiab Hloov Kho Kev Noj Qab Haus Huv (PATH) Kev Muaj Peev Xwm thiab Cov Txheej Txheem Hloov Kho, Kev nthuav dav, thiab Kev Txhim Kho (CITED) Daim Ntawv Thov Round 4
On January 6, DHCS opened the PATH CITED Round 4 application window, which includes funding opportunities to support the implementation of the new transitional rent Community Support. The PATH CITED initiative provides funding to build the capacity and infrastructure of on-the-ground partners, including community-based organizations, hospitals, county agencies, Tribes, and others, to successfully participate in Medi-Cal. All organizations providing the transitional rent Community Support must do so in partnership with their county behavioral health department. To demonstrate this partnership, all CITED applicants planning to request funding to support the transitional rent Community Support must also submit a Letter of Support in collaboration with the county behavioral health department.
Hnub kawg rau kev thov rau PATH CITED Round 4 cov nyiaj pab yog 11:59 teev tsaus ntuj PDT rau lub Tsib Hlis 2, 2025. Cov ntaub ntawv qhia thiab daim ntawv thov muaj nyob rau ntawm PATH CITED lub vev xaib. Thov xa cov lus nug rau cited@ca-path.com.