Tsib Hlis 27, 2025
Xov xwm tshaj plaws
Daim Ntawv Qhia Txog Tus Cwj Pwm Tshiab Kev Noj Qab Haus Huv (BHSA) Kev Txhawb Nqa Nyiaj Tau Los thiab Kev Npaj
DHCS tau tso tawm Daim Ntawv Qhia Txog Kev Ruaj Ntseg ntawm BHSA nrog cov lus qhia los txo qhov sib txawv ntawm cov Nyiaj Pabcuam Kev Noj Qab Haus Huv ntawm Lub Nroog (BHSF). Cov lus pom zoo no yog los pab cov nroog tswj hwm cov nyiaj tau los tas li, tswj cov kev pabcuam thaum muaj kev lag luam nce thiab nqis, thiab coj kev kwv yees ntau dua thiab kev lav ris rau cov nyiaj txiag kho mob hauv zos.
Pawg Neeg Ua Haujlwm Revenue Stability Workgroup ntawm BHSA, uas muaj cov thawj coj hauv xeev thiab cov nroog, yuav tsum tsim thiab pom zoo cov kev daws teeb meem los txo qhov kev hloov pauv ntawm cov nyiaj tau los ntawm BHSA thiab tawm tswv yim txog cov qib kev khaws cia kom zoo los txhawb kev ruaj khov ntawm cov kev pab cuam thiab cov kev pabcuam ntawm lub nroog. Nws tau tshuaj xyuas thiab tshuaj xyuas cov nyiaj tau los tam sim no thiab keeb kwm uas tau tsim los ntawm MHSA thiab BHSA thiab cov theem khaws cia kom zoo los tsim cov lus pom zoo.
Lub Chaw Haujlwm Saib Xyuas Kev Tswj Xyuas Hauv Xeev yuav txuas ntxiv ua raws li cov txheej txheem tam sim no los faib cov nyiaj pab hauv zos BHSA rau cov nroog txhua hli. Lub hom phiaj yog los sib npaug ntawm kev faib cov nyiaj tau los ntawm kev pab hauv zos thiab kev ruaj khov ntawm cov kev pab cuam, pab cov nroog npaj tau zoo thiab muab cov kev pabcuam kev noj qab haus huv tseem ceeb thaum muaj nyiaj poob qis. Cov ntsiab lus tseem ceeb suav nrog:
- Kev siv nyiaj txhua xyoo raws li qhov nruab nrab peb xyoos, hloov kho rau kev nce nqi.
- Tshiab txwv txwv (10-15 feem pua, nyob ntawm lub nroog loj).
- Ib zaug yuav tsum tau siv nyiaj ntau dhau ntawm 2026-2029.
- Yooj yim los kho cov peev nyiaj yog tias cov nyiaj tau los poob.
- Ntau pob tshab, nrog rau kev tshaj tawm pej xeem thiab cov tswv yim hauv zej zog.
Txoj kev no txhawb nqa California lub zeem muag ntawm Kev Noj Qab Haus Huv Lub Siab rau Txhua Tus los ntawm kev txhawb nqa kev ruaj khov, kev pom tseeb, thiab kev saib xyuas kev noj qab haus huv hauv zej zog. Txoj cai lij choj hauv xeev yuav tsum tau ua kom muaj cov lus pom zoo los ntawm BHSA Revenue Stability Workgroup Report.
Kev Pabcuam Hauv Zej Zog Qhia Txog Tus Nqi Thaum Ntxov Thaum Ua Raws Li Medi-Cal Cov Tswv Cuab xav tau
DHCS nyuam qhuav xa mus rau Centers for Medicare & Medicaid Services (CMS) nws cov Kev Txhawb Nqa Hauv Zej Zog, lossis Hloov Chaw Pabcuam (ILOS), Daim Ntawv Qhia Txhua Xyoo[TO1] , uas tshuaj xyuas qhov kev nce qib thiab qhov cuam tshuam ntawm Medi-Cal Community Supports hauv xyoo 2024. Thawj zaug, daim ntawv tshaj tawm kuj suav nrog kev tshuaj xyuas kev siv nyiaj tsim nyog rau xyoo 2023. Daim ntawv tshaj tawm qhia txog cov kev ua tiav tseem ceeb, xws li kev txo qis kev mus ntsib chav kho mob ceev, kev pw hauv tsev kho mob, thiab kev siv kev saib xyuas mus sij hawm ntev, taw qhia rau cov pov thawj thaum ntxov ntawm ob qho tib si kev txhim kho kev noj qab haus huv thiab txo cov nqi thaum piv rau cov kev pabcuam uas lawv tab tom hloov, xws li kev pw hauv tsev kho mob, chav kho mob ceev, thiab kev pabcuam saib xyuas mus sij hawm ntev. Ntawm 12 qhov kev txhawb nqa hauv zej zog uas tau kawm, cuaj qhov twb tau ua pov thawj tias tsim nyog tus nqi, thiab peb qhov seem yuav ua pov thawj tias tsim nyog tus nqi dhau sijhawm.
Daim ntawv tshaj tawm kuj piav qhia txog kev txhim kho kev ua haujlwm uas DHCS thiab cov phiaj xwm kev saib xyuas kev tswj hwm (MCP) tau ua los nthuav cov kev pabcuam, loj hlob cov tes hauj lwm muab kev pabcuam, thiab txhawb nqa kev siv. Txawm hais tias kev nce qib tau zoo heev los xij, daim ntawv tshaj tawm kuj tseem qhia txog cov teeb meem thiab cov cib fim rau kev txhim kho ntxiv, kom ntseeg tau tias cov kev pabcuam no txuas ntxiv hloov pauv kom tau raws li qhov xav tau ntawm cov tswv cuab Medi-Cal.
Kev hloov kho tshiab
Medi-Cal Kev Lag Luam MCP Kev Muag Khoom Hloov Tshiab
DHCS yuav ncua qhov kev yuav khoom Medi-Cal MCP tom ntej tsawg kawg yog ob xyoos. Qhov kev sib tw yuav khoom rau MCPs tom ntej yuav pib tsis pub dhau xyoo 2029, nrog rau cov ntawv cog lus yuav pib siv tsis pub dhau xyoo 2031. DHCS tau qhia ua ntej lawm tias kev yuav khoom dua rau cov MCPs lag luam yuav raug ua ib zaug txhua tsib xyoos. Raws li lub sijhawm teem tseg no, DHCS yuav tsum tau tso tawm Daim Ntawv Thov Kev Pom Zoo (RFP) hauv xyoo 2027 rau hnub cog lus uas siv tau rau lub Ib Hlis 1, 2029.
Lub sijhawm ntxiv no yuav tso cai rau DHCS tsom mus rau cov haujlwm tseem ceeb ntawm California Advancing and Innovating Medi-Cal (CalAIM). Nws tseem yuav pab tswj kev ruaj khov rau cov tswv cuab thiab txhawb nqa kev txhim kho tas mus li rau qhov zoo ntawm kev saib xyuas thiab kev nkag mus tau, thaum tseem txhawb nqa kev vam meej mus sij hawm ntev ntawm Medi-Cal managed care program.
Raws li txoj cai tam sim no, cov ntawv cog lus MCP yuav raug txuas ntxiv txhua xyoo ua raws li cov kev cai ntawm daim ntawv cog lus uas tau teev tseg hauv Daim Ntawv Qhia E, 1.1.15 ntawm Daim Ntawv Cog Lus Xyoo 2024 Managed Care Boilerplate. Cov ntawv cog lus MCP tam sim no yuav raug txuas ntxiv txij lub Ib Hlis 1, 2026, mus txog rau lub Kaum Ob Hlis 31, 2026, los ntawm cov txheej txheem txhua xyoo uas tau teeb tsa. DHCS tseem cog lus tias yuav txhawb kom muaj kev koom ua ke, yoog tau, thiab teb tau sai uas txhawb nqa Medi-Cal program thiab xyuas kom cov neeg California tau txais kev kho mob zoo. Thov mus saib nplooj ntawv Medi-Cal Managed Care kom paub ntxiv.
Kev Hloov Kho Hniav Tswj Kev Kho Hniav
Thaum lub lim tiam ntawm lub Tsib Hlis 26, DHCS yuav xa ntawv ceeb toom 30 hnub rau kwv yees li 350,000 tus tswv cuab Medi-Cal hauv Sacramento thiab Los Angeles counties kom ceeb toom rau lawv txog kev hloov pauv tom ntej rau lawv cov kev pabcuam kho hniav, siv tau rau lub Xya Hli 1, 2025. Daim ntawv ceeb toom rau cov tswv cuab piav qhia txog yam uas yuav hloov pauv, yog tias tus tswv cuab xav tau kev xaiv txoj kev npaj, kev tiv thaiv kev saib xyuas txuas ntxiv ntawm tus tswv cuab, thiab lwm yam ntaub ntawv tseem ceeb, thiab yuav suav nrog pob ntawv sau npe rau kev saib xyuas Medi-Cal.
Cov tswv cuab hauv Sacramento County uas tam sim no tau sau npe rau hauv Access Dental Plan lossis dental fee-for-service (FFS) yuav tsum xaiv ib txoj kev npaj kho hniav tshiab, thaum cov tswv cuab hauv Los Angeles County uas tsis xaiv ib txoj kev npaj kho hniav yuav nyob hauv FFS. Cov tswv cuab uas tam sim no tau sau npe nrog Health Net lossis Liberty yuav tsis raug cuam tshuam los ntawm cov kev hloov pauv no. Tsis tas li ntawd xwb, kev hloov cov phiaj xwm kho hniav uas tswj hwm los ntawm kws kho hniav yuav tsis cuam tshuam rau kev pab them nqi lossis cov txiaj ntsig ntawm Medi-Cal.
Medi-Cal Health Care Options tab tom ua ib qho kev sib tham hu xov tooj rau cov tswv cuab uas tau txais pob ntawv sau npe rau kev saib xyuas kev kho mob. Thaum lub sijhawm hu xov tooj no, cov neeg sawv cev ntawm HCO yuav tshuaj xyuas cov kev xaiv ntawm txoj kev npaj kho hniav uas muaj, teb cov lus nug, thiab pab txhawb kev sau npe rau hauv txoj kev npaj uas tus tswv cuab xaiv los ntawm xov tooj. DHCS tau tsim nplooj ntawv web Dental Transition Member Notices rau cov tswv cuab kom saib cov ntawv ceeb toom thiab lwm cov ntaub ntawv hais txog kev hloov pauv Dental Managed Care.
Medi-Cal Requirements thiab Cov txheej txheem rau npe rau cov kws kho mob
Txij li Lub Yim Hli 1, 2025, cov chaw muab tshuaj uas tuav daim ntawv pov thawj Clinical Laboratory Improvement Amendments (CLIA) Certificate of Waiver thiab daim ntawv pov thawj California Clinical Laboratory Registration tam sim no yuav them nqi rau cov kev kuaj mob CLIA-waived uas muab rau hauv qhov kev xyaum ntawm tus kws muag tshuaj raws li tau txhais los ntawm California State Board of Pharmacy thiab tau tso cai hauv Business and Professions Code Section 4052.4. Cov kws muab tshuaj yuav tsum thov rau npe rau hauv qhov kev pab cuam Medi-Cal los ntawm kev xa daim ntawv thov rau npe rau tus kws muab tshuaj Medi-Cal online, nrog rau txhua cov ntaub ntawv txhawb nqa.
On June 10, from 10 to 11 a.m. PDT, DHCS will hold a public stakeholder hearing via webinar (advance registration required) to discuss the draft regulatory provider bulletin entitled, “Medi-Cal Enrollment Requirements and Procedures for Pharmacy Providers that Hold a Clinical Laboratory Improvement Amendments (CLIA) Certificate of Waiver.”
Cov lus tawm tswv yim, cov lus nug, lossis cov lus qhia sau tuaj yeem xa tuaj thaum lub rooj sib hais hauv kev sib tham hauv webinar. Rau cov neeg uas tuaj koom tsis tau, cov lus sau yuav tsum xa tuaj ua ntej 5 teev tsaus ntuj PDT rau lub Rau Hli 10 kom txiav txim siab tshaj tawm. Thaum xa cov lus tawm tswv yim sau ua ntawv, thov xyuas kom meej tias tus neeg tawm tswv yim thiab lub koom haum/koom haum uas sawv cev rau tau txheeb xyuas hauv cov lus tawm tswv yim. Thov xa cov lus tawm tswv yim sau ntawv mus rau DHCSPEDStakeholder@dhcs.ca.gov. Raws li cov lus tawm tswv yim ntawm pej xeem tau txais, DHCS yuav tshaj tawm tsab ntawv xov xwm kawg rau ntawm cov chaw muab kev pabcuam Medi-Cal thiab DHCS Provider Enrollment Division lub vev xaib.
Koom nrog peb pab neeg
DHCS tab tom nrhiav ib tus neeg muaj peev xwm thiab muaj kev txhawb siab los ua haujlwm xws li:
- Chief, Capitated Rates Development Division. Tus Thawj Coj yog tus thawj coj kev teeb tsa tus nqi rau Medi-Cal cov phiaj xwm saib xyuas thiab Cov Kev Pabcuam Txhua-Inclusive Care rau Cov Neeg Laus. Cov dej num suav nrog kev siv cov txheej txheem actuarial los tsim cov nqi capitation thiab saib xyuas kev txhim kho thiab kev siv cov cai thiab cov txheej txheem rau kev them nyiaj rov qab. Tsis tas li ntawd, Tus Thawj Saib Xyuas kom paub meej txog cov txheej txheem nyiaj txiag ua raws li kev xa khoom zoo ntawm kev saib xyuas kev noj qab haus huv thiab ua raws li lub xeev thiab tseemfwv txoj cai lij choj, cov cai, thiab cov cai. Cov ntawv thov yuav tsum xa ua ntej lub Tsib Hlis 30.
- Tus Lwm Thawj Coj (ADD), Kev Pabcuam Tshuab Lag Luam (ETS). Lub luag haujlwm ADD tshiab no yuav tsim kev sib raug zoo ua haujlwm nrog DHCS Cov Neeg Ua Haujlwm, cov neeg koom tes hauv kev pab cuam, thiab cov neeg koom tes sab nraud, thiab pab nrog kev coj ua ntawm DHCS cov kev pab cuam thiab cov kev pabcuam IT. Tsis tas li ntawd xwb, ADD yuav ua lub luag haujlwm tseem ceeb hauv kev coj ua txoj kev tsim thiab kev siv cov cai IT, kev tsim qauv ntawm lub kaw lus, kev ruaj ntseg, kev txhim kho, thiab kev daws teeb meem rau DHCS cov kev pab cuam, suav nrog Medi-Cal thiab kev noj qab haus huv ntawm tus cwj pwm. Cov ntawv thov yuav tsum xa tuaj rau lub Rau Hli 2.
DHCS tab tom nrhiav neeg ua haujlwm rau nws txoj kev saib xyuas Medi-Cal, kev tshuaj xyuas cov ntaub ntawv, kev tsim nyog Medi-Cal, thiab lwm pab pawg. Yog xav paub ntxiv, thov mus saib lub vev xaib CalCareers.
Cov Rooj Sib Tham Cov Neeg Koom Tes thiab Webinar yuav los tom ntej
DHCS tshaj tawm cov rooj sib tham rau pej xeem uas yuav los txog rau ntawm Daim Ntawv Teev Npe ntawm Cov Xwm Txheej. DHCS muab kev pab dawb, suav nrog kev txhais lus, kev sau cov lus piav qhia tam sim ntawd, thiab kev hloov hom ntawv ntawm cov ntaub ntawv sib tham. Yog xav thov cov kev pabcuam, thov xa email rau DHCS ntawm qhov chaw nyob email tsim nyog tsawg kawg yog kaum hnub ua haujlwm ua ntej lub rooj sib tham.
Kev Pabcuam Ambassador Webinar Series: Birthing Care Pathway
Thaum lub Tsib Hlis 29, txij 11 teev sawv ntxov txog 12 teev tav su PDT, DHCS yuav tuav lub rooj sib tham hauv online uas yuav tsom mus rau DHCS txoj kev pib Birthing Care Pathway (yuav tsum tau sau npe ua ntej). Lub rooj sib tham hauv online no yuav muab cov ntaub ntawv hais txog cov kev pabcuam yug menyuam rau cov tswv cuab Medi-Cal uas cev xeeb tub thiab tom qab yug menyuam txij thaum cev xeeb tub mus txog 12 lub hlis tom qab yug menyuam thiab tshuaj xyuas cov ntsiab lus tseem ceeb los ntawm Daim Ntawv Qhia Txog Kev Saib Xyuas Menyuam Yug uas tau tshaj tawm rau lub Ob Hlis 4. Qhov kev pib no pab kom ntseeg tau tias cov tswv cuab Medi-Cal muaj kev nkag mus rau kev saib xyuas zoo thiab ncaj ncees los txhim kho cov txiaj ntsig kev noj qab haus huv ntawm niam thiab txo qhov sib txawv. Cov Neeg Sawv Cev Rau Kev Pab Cuam kuj tseem yuav kawm txog DHCS cov platform social media, uas muab cov ntaub ntawv tshiab tshaj plaws txog cov ncauj lus tseem ceeb uas tuaj yeem pab tau ob qho tib si Cov Neeg Sawv Cev Rau Kev Pab Cuam thiab cov tswv cuab Medi-Cal. Yuav muaj kev txhais lus ua lus Mev tib lub sijhawm thaum lub sijhawm webinar.
Hauv Case Koj Tsis Tau Nws
Thov rau Daim Ntawv Thov (RFA): Cov Kev Pabcuam Vaj Tse yooj yim
On May 7, DHCS announced the Flexible Housing Subsidy Pools (“Flex Pools”) RFA. DHCS will select up to 10 local teams to participate in the Flex Pools TA Academy and receive Flex Pools planning grants of approximately $150,000. The launch of Medi-Cal Transitional Rent and Behavioral Health Services Act (BHSA) Housing Interventions creates an unprecedented opportunity to help people achieve better health outcomes through housing stability.
Cov Chaw Ua Si Flex yog tsim los pab cov nroog thiab cov koom haum Tribal txhim kho kev ruaj ntseg ntawm vaj tse rau cov tib neeg uas muaj lossis muaj kev pheej hmoo ntawm kev tsis muaj tsev nyob. Lawv yog ib tus qauv tsim hauv zos los sib koom tes pab txhawb kev xauj tsev thiab siv cov kev txhawb nqa vaj tse uas muaj kom zoo tshaj plaws, sib phim cov haujlwm ntawm cov phiaj xwm kev saib xyuas, cov koom haum kev noj qab haus huv hauv nroog, thiab lwm tus neeg koom tes tseem ceeb hauv cov kev pabcuam tsis muaj tsev nyob thiab cov txheej txheem rov qab nyob. Cov ntawv thov yuav tsum xa mus rau DHCS thaum 5 teev tsaus ntuj PDT rau lub Rau Hli 13, 2025. Cov koom haum uas raug xaiv yuav tau txais kev ceeb toom thaum Lub Xya Hli 2025. Yog xav paub ntxiv thiab thov, thov mus saib lub vev xaib DHCS Housing for Health .
HCBA Waiver Amendment Application – 30-Hnub Public Comments Period
Thaum Lub Tsib Hlis 12, DHCS tau tshaj tawm daim ntawv qauv ntawm 2025 Home and Community-Based Alternatives (HCBA) kev hloov kho rau 30 hnub rau pej xeem tawm tswv yim, ua ntej xa daim ntawv kawg rau CMS kom rov tso cai dua. Daim ntawv tso cai HCBA tso cai rau cov neeg sau npe tsim nyog tau txais cov kev pabcuam pom zoo los ntawm lub tshuab xa khoom hauv xov tooj. Cov kev hloov pauv uas tau pom zoo hauv kev hloov kho kev zam txim suav nrog:
- Qhia kom meej cov kev taw qhia thiab kev cia siab rau cov kev pabcuam telehealth.
- Tshem tawm Cov Chaw Kho Mob Nruab Nrab rau Kev Kho Mob Tsis Muaj Kev Kho Mob Nruam (ICF/DD-CN) uas tsis yog qhov cua thiab qhov cua-dependent cov txiaj ntsig thiab kev teeb tsa, vim lawv tab tom hloov mus rau Medicaid State Plan raws li cov txiaj ntsig kev saib xyuas mus sij hawm ntev.
Qhov kev hloov pauv no ua rau California txhawb nqa txoj kev siv zog los ua raws li Txoj Cai Kawg ntawm Medicaid Home and Community-Based Settings (HCBS) los ntawm kev txhawb nqa kev xa cov kev pabcuam hauv cov chaw sib koom ua ke, hauv zej zog uas txhawb nqa kev xaiv tus kheej thiab kev ywj pheej.
DHCS caw txhua tus neeg uas xav paub txog qhov kev hloov kho thiab cov lus qhia tawm tswv yim ntawm nplooj ntawv web DHCS HCBA Waiver nyob rau hauv Daim Ntawv Thov Hloov Kho HCBA Waiver - 30-Hnub Cov Lus Qhia rau Pej Xeem txij lub Tsib Hlis 12, 2025 - Lub Rau Hli 12, 2025 . Txhua cov lus tawm tswv yim yuav tsum tau txais los ntawm Lub Rau Hli 12, 2025. Yog koj muaj lus nug dab tsi, thov xa email rau hcbspolicy@dhcs.ca.gov.
Medicaid State Plan Amendment (SPA) – 30-hnub Public Comments Period
Thaum Lub Tsib Hlis 12, DHCS tau tshaj tawm ICF/DD-CN: Kev Hloov Pauv ntawm Cov Nyiaj Pab/Kev Teeb tsa SPA (SPA #25-0026) rau lub sijhawm 30 hnub rau pej xeem tawm tswv yim, ua ntej xa daim ntawv kawg rau CMS kom pom zoo. ICF/DD-CNs muab kev saib xyuas tus kheej 24 teev, kev pabcuam kev loj hlob, thiab kev saib xyuas neeg mob rau cov tib neeg uas muaj kev tsis taus ntawm kev loj hlob uas muaj kev xav tau kev saib xyuas neeg mob tas mus li thiab tau txais daim ntawv pov thawj los ntawm tus kws kho mob thiab kws phais mob tias tsim nyog tau txais kev saib xyuas neeg mob tas mus li. Cov kev pabcuam no tam sim no muab los ntawm HCBA waiver. Daim SPA no yuav hloov qhov kev pab/chaw teeb tsa ICF/DD-CN los ntawm HCBA waiver mus rau Medicaid State Plan ua chaw teeb tsa kev saib xyuas mus sij hawm ntev. Qhov kev hloov pauv no ua rau California txoj kev siv zog los ua raws li txoj cai kawg ntawm tsoomfwv HCBS los ntawm kev txhawb nqa kev xa cov kev pabcuam hauv kev sib koom ua ke, hauv zej zog uas txhawb nqa kev xaiv tus kheej thiab kev ywj pheej. Txhua cov lus tawm tswv yim yuav tsum tau txais los ntawm Lub Rau Hli 12, 2025. Yog koj muaj lus nug dab tsi, thov xa email rau PublicInput@dhcs.ca.gov.