Kev Tiv Thaiv Mob Ntshav Qab Zib
Txhawm rau tso npe ua Tus Nqi-Rau-Service Medi-Cal tus kws kho mob, Txoj Kev Tiv Thaiv Mob Ntshav Qab Zib (DPP) yuav tsum ua kom tau raws li cov cai thiab cov qauv kev tso npe rau Medi-Cal tam sim no, cov kev cai uas tau teev tseg hauv daim ntawv tshaj tawm no, thiab qee qhov kev tso npe nkag thiab cov qauv rau Medicare Diabetes Prevention Program tau teev tseg hauv 42 CFR Seem 424.205 raws li hauv qab no. Cov neeg muab kev pabcuam DPP yuav tsum xa lawv daim ntawv thov los ntawm PAVE (Kev Pabcuam Kev Pabcuam thiab Kev Pov Hwm rau Kev Sau Npe).
suav nrog ntawm no yog qhov kev nthuav qhia powerpoint los pab koj pib daim ntawv thov DPP hauv PAVE system. Nws kuj piav txog cov txheej txheem tshuaj xyuas daim ntawv thov.
Yuav tsum muaj rau npe kawm ua DPP
Raws li qhov xwm txheej ntawm kev tso npe kawm, DPP yuav tsum muaj qhov tseem tos, ua ntej, lossis tag nrho lees paub tias yog DPP los ntawm Lub Chaw Tiv Thaiv thiab Tiv Thaiv Kab Mob. Saib 42 CFR 424.205, Cov kev xav tau rau Medicare Diabetes Prevention Program cov neeg muab khoom.
Tsis tas li ntawd, DPP yuav tsum tuav tsawg kawg ib qho chaw tswj hwm hauv California. Ib qho "qhov chaw tswj hwm" txhais tau tias yog lub cev qhov chaw cuam tshuam nrog DPP cov haujlwm, thiab qhov twg DPP cov kev pabcuam yuav lossis tsis tuaj yeem muab tau. Saib 42 CFR 424.205.
Raws li Lub Chaw Rau Medicare thiab Medicaid Services 'Federal Register, DHCS lees paub tias cov kev pabcuam DPP tuaj yeem tshwm sim tsis yog ntawm cov chaw tswj hwm uas muaj thiab ua haujlwm los ntawm tus neeg thov, tab sis kuj tseem tuaj yeem tshwm sim ntawm "kev teeb tsa hauv zej zog." Ib qho "kev teeb tsa hauv zej zog" txhais tau tias yog qhov chaw uas tus neeg muab kev pabcuam DPP lossis tus neeg thov tuaj yeem muab cov kev pabcuam DPP sab nraud ntawm lawv qhov chaw tswj hwm (piv txwv li - chaw ua si, chaw hauv zej zog, lub tsev teev ntuj hauv qab daus, thiab lwm yam) Saib 42 CFR 424.205.
Txhua tus neeg thov DPP thov kev txiav txim siab rau kev tso npe yuav tsum muaj tsawg kawg yog ib qhov chaw tswj hwm, thiab yuav tsum tshaj tawm txhua qhov chaw tswj hwm nrog lawv daim ntawv thov rau npe.
Kev tshuaj xyuas ntawm qhov chaw yuav tsum tshwm sim ntawm DPP tus kws kho mob lossis tus neeg thov kev pabcuam qhov chaw tswj hwm, txawm li cas los xij, tus neeg muab kev pabcuam DPP lossis tus neeg thov tsis tas yuav muab cov kev pabcuam DPP ntawm lawv qhov chaw tswj hwm. Tag nrho lwm qhov Kev Tsim Kho Chaw Ua Lag Luam raws li tau teev tseg hauv CCR, Title 22, Tshooj 51000.60 yuav siv tau rau tus neeg thov lossis tus kws kho mob qhov chaw tswj hwm.
DPPs tuaj yeem siv cov kws qhia ua phooj ywg los muab kev pabcuam DPP rau cov neeg tau txais txiaj ntsig Medi-Cal. Cov kws qhia ua phooj ywg yuav tsum raug xa los ntawm lossis nyob ntawm DPP qhov chaw tswj hwm. Cov kws qhia ntawv no yuav tsum tau txais thiab tuav lub National Provider Identifier (NPI) uas siv tau txhua lub sijhawm. Tsis tas li ntawd, tus kws qhia DPP yuav tsum TSIS TAU:
- Tam sim no muaj Medicaid lossis Medicare cov cai sau nqi raug tshem tawm thiab yuav tsum tsis txhob raug rau lub chaw sau npe rov qab;
- Tam sim no muaj nws cov cai sau nqi Medicaid raug txiav tawm vim los yog raug tshem tawm los ntawm Lub Xeev Medicaid lub koom haum;
- Tam sim no raug tshem tawm los ntawm lwm qhov kev pab cuam kho mob ntawm Tsoom Fwv Teb Chaws, raws li tau hais tseg hauv 42 CFR 1001.2, raws li tshooj 1128, 1128A, 1156, 1842, 1862, 1867 lossis 1892 ntawm Txoj Cai;
- Tam sim no raug tshem tawm, raug tshem tawm, lossis txwv tsis pub koom nrog lwm qhov tseem ceeb ntawm kev yuav khoom lossis tsis yog kev yuav khoom lossis kev ua haujlwm raws li Tsoom Fwv Teb Chaws Txoj Cai Tswjfwm Saib Xyuas Kev Ua Haujlwm thiab Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv thiab Tib Neeg Kev Pabcuam tsis yog kev yuav khoom ntawm 45 CFR part 76;
- Muaj, nyob rau hauv 10 xyoo dhau los, ib qho ntawm lub Xeev lossis Tsoom Fwv Teb Chaws raug txim txhaum cai hauv qab no.
- Kev ua txhaum cai rau tib neeg, xws li kev tua neeg, rape, kev ua phem, thiab lwm yam kev ua txhaum cai zoo sib xws uas tus neeg raug txim, raws li tau hais tseg nyob rau hauv 42 CFR 1001.2, muaj kev lees paub txhaum cai lossis raug txiav txim ua ntej kev hloov pauv.
- Kev ua txhaum nyiaj txiag, xws li extortion, embezzlement, income tax evasion, insurance fraud and other similar crimes for which the person was punished, as 42 CFR 1001.2, have a guithful plea or adjudicated pretrial diversion.
- Ib qho kev ua txhaum cai uas tau muab Medicare lossis nws cov neeg tau txais txiaj ntsig muaj kev pheej hmoo tam sim ntawd, xws li kev ua tsis ncaj ncees uas ua rau tus neeg raug txim, raws li tau hais tseg hauv 42 CFR 1001.2, muaj kev lees paub txhaum cai lossis raug txiav txim ua ntej kev txiav txim siab txog kev ua txhaum cai lossis kev ua txhaum cai.
- Txhua qhov kev ua txhaum cai uas tus neeg raug txim, raws li tau hais tseg hauv 42 CFR 1001.2, muaj kev lees paub txhaum cai lossis raug txiav txim ua ntej kev txiav txim siab uas yuav ua rau yuav tsum tau cais tawm raws li Tshooj 1128(a) ntawm Txoj Cai.
Yog tias DPP raug pom tias siv tus kws qhia ua phooj ywg uas tsis ua raws li cov qauv no, DPP daim ntawv thov rau npe yuav raug tsis lees paub. Saib 42 CFR 424.205.
Tam sim no cuv npe hauv Tsev Saib Xyuas Kev Noj Qab Haus Huv, Tsev Kho Mob Hauv Zej Zog, Cov Kws Kho Mob, Pawg Kws Kho Mob, Tsoom Fwv Teb Chaws Saib Xyuas Kev Noj Qab Haus Huv, Chaw Kho Mob Hauv Nroog, Chaw Kho Mob Dawb, Tsev Kho Mob Hauv Zej Zos, Chaw Kho Mob Ntau Yam, Lub Tsev Kho Mob Hauv Nroog Tsis cuam tshuam nrog cov tsev kho mob, txwv tsis pub cov chaw kho mob tsis tsim nyog, Tsev Kho Mob thiab Zej Zog Kev Pabcuam Hauv Zej Zog Cov Tsev Kho Mob Sab Nraud Hauv Nroog, thiab Kev Pabcuam Kev Noj Qab Haus Huv Indian tuaj yeem thov kom muab cov kev pabcuam DPP los ntawm kev xa daim ntawv ua tiav Kev thov hloov pauv ntxiv siv PAVE, nrog rau lawv qhov siv tau, tam sim no CDC Pending lossis tsab ntawv lees paub ua ntej lossis daim ntawv pov thawj ntawm Full CDC Recognition thiab ib daim ntawv teev npe ntawm txhua tus kws qhia ua phooj ywg, uas suav nrog txhua tus kws qhia lub npe, NPI tus lej, hnub yug, thiab Tus lej Xaus Saus. .
Cov kev cai thov ntxiv
Tsis tas li ntawd, cov neeg thov kev pab tiv thaiv kab mob ntshav qab zib yuav tsum xa tag nrho cov khoom hauv qab no nrog rau lawv daim ntawv thov rau npe:
- Ib tsab ntawv npog qhia txog lawv qhov kev thov rau npe raws li Txoj Haujlwm Tiv Thaiv Mob Ntshav Qab Zib thiab cov npe ntawm txhua qhov chaw tswj hwm ntawm DPP tus kws kho mob lossis tus neeg thov;
- Ib daim qauv ntawm tus neeg thov DPP lossis tus neeg muab kev pabcuam uas siv tau, tam sim no, CDC Pending lossis tsab ntawv lees paub ua ntej, lossis daim ntawv theej tam sim no siv tau ntawm lawv Daim Ntawv Pov Thawj CDC Pom Zoo. Cov kws kho mob yuav tsum tau txais thiab tswj xyuas qhov kev lees paub / ntawv pov thawj no txhua lub sijhawm. Kev poob qis, ua ntej, lossis kev lees paub tag nrho yuav ua rau raug tshem tawm ntawm kev koom nrog hauv Medi-Cal qhov kev pab cuam;
- Ib daim ntawv teev npe ntawm txhua tus kws qhia ua phooj ywg uas suav nrog txhua tus kws qhia lub npe, NPI tus lej, hnub yug, thiab Tus lej Xaus Saus;
- Cov neeg thov kev tso npe tshiab hauv DPP yuav tsum xa ib daim ntawv theej ntawm DOJ Daim Ntawv Thov Kev Pabcuam Hauv Kev Tshawb Fawb (BCIA 8016) rau txhua tus neeg xav tau nrog lawv daim ntawv thov, hnub tim thiab qhia tias txhua tus nqi tau them los ntawm "PAID" stamp los ntawm pej xeem Live Scan tus neeg teb xov tooj lossis daim ntawv txais nyiaj. Yog xav paub meej txog cov txheej txheem thiab cov uas yuav tsum tau xa daim BCIA 8016, thov mus saib daim ntawv tshaj tawm hu ua "Medi-Cal Requirement to Submit Fingerprints for a Criminal Background Check "
- Raws li Lub Chaw Rau Medicare & Medicaid Services' Calendar Xyoo 2022 Tus Kws Kho Mob Tus Nqi Teem Sijhawm Kawg, DPP cov kws kho mob tsis raug suav hais tias yog cov chaw muab kev pabcuam. Yog li ntawd, txhua daim ntawv thov tau txais los yog tom qab Lub Ib Hlis 1, 2022, yuav tsis tas yuav them tus nqi thov ntxiv lawm.
