Xov xwm tshaj plaws
Rov qab mus rau Lub Ob Hlis 2022 Stakeholder Communications Update
Managed Care Plan Request for Proposal (RFP) Hloov tshiab
Thaum Lub Ob Hlis 9, DHCS tau tshaj tawm RFP rau nws cov neeg cog lus ua lag luam Medi-Cal managed care plan (MCP) uas yuav txhais dua tshiab txog kev xa kev saib xyuas rau ntau dua 12 lab tus neeg California. Daim RFP tsa lub xeev cov kev cia siab ntawm MCPs hauv qhov kev pab cuam Medi-Cal los ntawm daim ntawv cog lus tshiab thiab muaj zog uas yuav siv rau txhua txoj kev npaj. Qhov kev npaj Medi-Cal uas tsis tau muaj dua li no, thaum siv tau, yuav hloov pauv kev muab kev kho mob rau cov neeg California uas tau sau npe rau hauv Medi-Cal managed care.
DHCS tab tom nrhiav MCP cov neeg koom tes cog lus los txhawb kev ncaj ncees, kev ua tau zoo, kev nkag tau, kev lav phib xaub, thiab pob tshab kom txo qis kev noj qab haus huv tsis sib xws thiab txhim kho cov txiaj ntsig kev noj qab haus huv rau cov tswv cuab Medi-Cal. Cov MCPs raug xaiv yuav ua raws li cov cai tshiab thiab txhim kho kom ntseeg tau tias cov tswv cuab tau txais kev pabcuam kev noj qab haus huv tsim nyog thaum xav tau, suav nrog kev pabcuam kev noj qab haus huv thiab kev tswj xyuas kev saib xyuas uas tseem ceeb rau kev txhim kho cov pejxeem kev noj qab haus huv thiab kev noj qab haus huv. Los ntawm cov txheej txheem RFP, DHCS tab tom txhim kho nws txoj kev saib xyuas ntawm cov neeg koom tes nrog cov phiaj xwm thiab lawv cov neeg ua haujlwm ua haujlwm ua haujlwm kom ntseeg tau tias muaj kev pom tseeb thiab kev lav phib xaub ntau dua.
Daim ntawv thov RFP yog ib feem ntawm cov peev txheej loj dua ntawm lub xeev rau kev noj qab haus huv thiab kev nyob zoo ntawm txhua tus neeg California uas suav nrog CalAIM. Cov lus pom zoo los ntawm MCPs yuav tsum xa rau lub Plaub Hlis 11, 2022. DHCS yuav muab cov ntawv cog lus rau lub caij nplooj zeeg xyoo 2022, thiab cov ntawv cog lus tshiab tau teem sijhawm pib rau lub Ib Hlis 1, 2024.
Thaum Lub Ob Hlis 15, DHCS tau tuav lub rooj sib tham hauv online rau cov tswv cuab, cov neeg tawm tswv yim, cov kws kho mob, cov phiaj xwm kho mob, thiab lwm tus neeg koom nrog los qhia txog yuav ua li cas DHCS yuav siv MCP RFP thiab cov ntawv cog lus tswj hwm kev saib xyuas los txhawb DHCS lub hom phiaj los txhim kho txoj kev xa khoom kho mob rau cov tswv cuab Medi-Cal.
Thaum Lub Ob Hlis 24, DHCS yuav tuav lub rooj sib tham hauv web ua ntej kev thov los ntawm 1 - 2:30 teev tsaus ntuj tshwj xeeb rau MCP kev yuav khoom thiab RFP tso tawm rau Lub Ob Hlis 9; Sau npe rau RFP lub rooj sib tham hauv web
Mus saib MCP lub vev xaib yuav khoom kom paub ntau ntxiv. Visit the RFP webpage to view the RFP.
Medi-Cal Rx Kev Hloov Kho Kev Ua Haujlwm
On January 1, DHCS transitioned the Medi-Cal pharmacy benefit of more than 14 million Medi-Cal members to a single delivery system, a change that will benefit members and result in substantial savings. As is the case with any large project, some implementation issues were to be expected, and DHCS’ vendor, Magellan, is addressing those as quickly as possible. DHCS is also ensuring that providers are kept updated, and that relevant information is communicated to them via e-mail blasts, provider newsflashes, information on the DHCS and Medi-Cal Rx websites, and direct provider outreach. Our actions are designed to ensure that Medi-Cal members can get the prescription drugs they need when they need them. For questions or comments related to Medi-Cal Rx, please email RxCarveOut@dhcs.ca.gov.
California Advancing and Innovating Medi-Cal (CalAIM) Hloov tshiab
Thaum Lub Kaum Ob Hlis 29, 2021, DHCS tau txais kev pom zoo ntawm CalAIM Tshooj 1115 Kev Qhia, CalAIM Tshooj 1915 (b) kev zam, thiab Medi-Cal State Plan Amendments los ntawm tsoomfwv Meskas Lub Chaw rau Medicare & Medicaid Services (CMS). Cov kev pom zoo no muab lub hwj chim los tsim CalAIM, kev cog lus mus sij hawm ntev los hloov pauv thiab txhawb nqa Medi-Cal - lub hauv paus tseem ceeb ntawm California txoj kev kho mob.
CalAIM shifts Medi-Cal to a population health approach, prioritizing prevention, addressing social drivers of health, and transforming services for communities who historically have been under-resourced and faced structural racism in the health care system. CalAIM is a bold transformation, putting people’s needs at the center of care and setting the pace for transformation of the entire health care sector.
Thaum Lub Ib Hlis 14, DHCS tau tuav lub rooj sib tham hauv online los muab kev piav qhia txog CalAIM Tshooj 1115 Kev Qhia thiab 1915 (b) kev zam uas nyuam qhuav pom zoo. Saib qhov kev nthuav qhia zam txim ntawm CalAIM Tshooj 1115 rau lub Ib Hlis 14, 1915(b).
Medi-Cal Qhov Kev Pab Cuam Tiv Thaiv Kab Mob Khaus Viv-19
DHCS tab tom faib nyiaj txog li $350 lab txhawm rau txhawb txhawb kev siv tshuaj tiv thaiv COVID-19 hauv Medi-Cal tswj kev saib xyuas kev noj qab haus huv txij lub Cuaj Hlis 1, 2021, mus txog Lub Ob Hlis 28, 2022. Medi-Cal MCPs tsim nyog tau txais nyiaj txhawb zog rau cov dej num uas tsim los kaw qhov sib txawv ntawm kev txhaj tshuaj tiv thaiv nrog lawv cov tswv cuab, thiab hais txog qhov tsis sib xws ntawm cov tshuaj tiv thaiv rau cov hnub nyoog thiab haiv neeg / haiv neeg. MCPs tuaj yeem khwv tau txog $ 50 lab rau kev ua tiav cov txheej txheem ntsuas thiab $ 200 lab rau cov txiaj ntsig kev ntsuas, nrog $ 100 lab muaj rau MCPs los siv rau cov tswv cuab ncaj qha.
Txij li lub Cuaj Hlis 1, 2021, tag nrho 25 lub MCPs uas muaj kev pabcuam puv ntoob thiab ib txoj kev npaj kho mob tshwj xeeb rau cov pej xeem tau txais kev pom zoo rau kev koom nrog hauv qhov kev pab cuam. Lub sijhawm txheeb xyuas qhov tshwm sim thawj zaug tau xaus rau lub Kaum Hli Ntuj hnub tim 31. Nruab nrab ntawm lub Cuaj Hlis 1 thiab Lub Kaum Hli 31, txhua txoj kev npaj tau tshaj tawm tias muaj kev txhim kho hauv peb qhov kev ntsuas txiaj ntsig nruab nrab thiab tag nrho xya qhov kev ntsuas txiaj ntsig ntawm kev txhaj tshuaj tiv thaiv kab mob. Thoob plaws lub xeev, lub hom phiaj rau Kev Ntsuas 3 tau raug ua tiav, txhim kho feem pua ntawm cov kws kho mob thawj zaug hauv cov tes hauj lwm MCP uas muab tshuaj tiv thaiv COVID-19 hauv lawv chaw ua haujlwm los ntawm 49.3 feem pua mus rau 56.8 feem pua. Ntxiv rau qhov ntawd, yuav luag ib feem peb ntawm qhov sib txawv ntawm cov nqi txhaj tshuaj tiv thaiv COVID-19 ntawm Medi-Cal thiab tag nrho cov pej xeem California hnub nyoog 12-25 tau kaw lawm, thiab yuav luag ib feem peb ntawm qhov sib txawv ntawm cov nqi txhaj tshuaj tiv thaiv COVID-19 ntawm tag nrho cov pej xeem Medi-Cal thiab cov pej xeem Dub/African American thiab American Indian/Alaska Native Medi-Cal tau kaw lawm. Tus nqi txhaj tshuaj tiv thaiv kab mob tau txuas ntxiv zoo dua los ntawm hnub thib ob ntawm kev paub txog qhov tshwm sim ntawm Lub Ib Hlis 2, 2022, tab sis thoob plaws lub xeev tsis tau ua tiav DHCS lub hom phiaj ntawm kev kaw ob feem peb ntawm qhov sib txawv rau ib qho ntawm xya qhov kev ntsuas hloov tshiab ntawm kev txhaj tshuaj tiv thaiv kab mob. Cov ntaub ntawv rau lub Ib Hlis 2 rau peb qhov kev ntsuas qhov tshwm sim nruab nrab tab tom raug sau ua ke.