Tsev Cov Chaw Muab Kev Pabcuam & Cov Neeg Koom Tes Kev Pab Cuam Txog Kev Muag Tshuaj thiab Kev Pab Cuam Saib Xyuas Qhov Muag Cov Lus Nug thiab Lus Teb Txog Kev Sib Txuas Lus Rau Me Nyuam Yaus (Q&A) Daim Ntawv​​ 

Pediatric Integration Question & Answer (Q&A) Document​​ 

Lub Ib Hlis 8, 2025 (supersedes Kaum Ob Hlis Ntuj 23, 2024 version)​​ 

Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS) tau tsim daim ntawv nug thiab teb txog kev koom ua ke ntawm cov menyuam yaus no raws li cov lus taw qhia ntawm cov neeg koom nrog tau txais thaum lub rooj sib tham tsis ntev los no thiab ntawm email. Cov lus hloov tshiab los ntawm cov ntawv Q&A ua ntej no tau muab sau ua ntawv tuab thiab muab tso rau hauv cov ntawv cim kom yooj yim rau kev tshuaj xyuas. DHCS lees paub tias tsis yog txhua lo lus nug thiab/lossis tej xwm txheej yuav raug hais txog hauv daim ntawv Q&A no tab sis yuav ua haujlwm los muab cov ntaub ntawv ntxiv rau hauv daim ntawv Cov Lus Nug Nquag Nug (FAQ) uas yuav tso tawm thiab luam tawm rau ntawm DHCS lub vev xaib Medi-Cal Rx thaum nruab nrab Lub Ib Hlis. Yog li no, yog tias koj muaj lus nug ntxiv, thov xa mus rau DHCS ntawm email ntawm RxCarveout@dhcs.ca.gov lossis rau pab pawg Medi-Cal Rx Education and Outreach ntawm email ntawm MediCalRxEducationOutreach@primetherapeutics.com kom lawv thiaj li suav nrog rau hauv daim ntawv FAQ tom ntej.​​ 

Cov Lus Nug​​ 

1. Kev Sib Koom Tes Hauv Menyuam Yaus yog dab tsi?​​ 

Pediatric Integration refers to the ending of the Medi-Cal Rx Transition Policy and reinstatement of utilization management (UM) edits/controls, including, but not limited to, quantity and frequency limitations and prior authorization (PA) request requirements for Medi-Cal members 21 years of age and younger. Pediatric Integration applies to both pediatric Medi-Cal and California Children’s Services (CCS) eligible members receiving services through Medi-Cal and CCS. [Effective January 31, 2025, the following will occur:]​​ 

» Rau cov kev kho mob/tshuaj sau ntawv tshiab, txhua qhov kev thov tshuaj yuav raug rau UM kev hloov kho/kev tswj hwm thiab PA cov cai, raws li tau teev tseg hauv Medi-Cal Rx thiab CCS cov cai pab cuam tshuaj.​​ 

» Rau kev kho mob/tshuaj kho mob txuas ntxiv mus, rau lub sijhawm tsis pub tsawg dua 60 hnub, yog tias qhov kev thov yuav tsis lees txais nrog Kev Tsis Lees Txais 75 (yuav tsum muaj PA) tab sis tus tswv cuab Medi-Cal muaj keeb kwm thov tsis ntev los no (lub sijhawm saib rov qab 15 lub hlis), qhov kev thov yuav them yam tsis tas yuav muaj PA ntxiv. Txoj hauv kev no yog los muab sijhawm ntxiv rau cov kws kho mob thiab cov kws sau ntawv kom hloov kho lawv cov txheej txheem sab hauv thiab npaj zoo dua rau cov kev xav tau PI, nrog rau xa cov PAs ua ntej.​​ 

  • Thov nco ntsoov tias kev kho mob/kev sau ntawv rau ib tug tswv cuab Medi-Cal tseem yuav raug rau txhua yam kev cai ntawm Medi-Cal Rx, suav nrog tab sis tsis txwv rau kev hloov kho UM rau qhov ntau thiab tsawg thiab zaus. Tej no yuav ua rau tsis lees txais daim ntawv thov rau lwm qhov laj thawj lossis xav tau daim ntawv thov PA los txiav txim siab qhov tsim nyog kho mob.​​ 
  • Tag nrho cov PAs tau pom zoo tam sim no yuav nyob twj ywm; cov hnub uas tau pom zoo thiab ua haujlwm PA yuav tsis raug hloov.​​ 
  • Thov nco ntsoov tias DHCS yuav tshaj tawm tsab ntawv ceeb toom 30-hnub ua ntej kev rov ua haujlwm ntawm Kev Tsis lees paub 75 (PA xav tau) rau kev kho mob txuas ntxiv / tshuaj, uas yuav tshwm sim tsis pub dhau lub Peb Hlis 31, 2025.​​ 

2. Txoj Cai Tswjfwm ntawm Pawg Neeg Muab Kev Pabcuam ntawm CCS yog dab tsi?​​ 

Raws li ib feem ntawm Pediatric Integration dag zog, DHCS tau tsim CCS Vaj Huam Sib Luag Tus Tswv Cuab Txoj Cai. Txoj cai no lees paub cov kws tshaj lij thiab kev lees paub ntxiv uas yuav tsum tau muaj los ntawm CCS Panel Providers, ua rau cov kws kho mob uas yog kws kho mob lossis Certified Nurse Practitioners (CNPs) sau ntawv rau txhua tus menyuam yaus Medi-Cal lossis CCS-cov tswvcuab uas muaj hnub nyoog 20 xyoo thiab yau dua yam tsis tau xa daim ntawv PA rau cov tshuaj them, nrog rau cov khoom noj khoom haus, tshwj tsis yog cov khoom noj khoom haus, thiab cov khoom noj khoom haus. Txoj cai no yog npaj los txo qis kev tswj hwm lub nra uas tsis tsim nyog thiab txhim kho kev nkag mus tau raws sijhawm rau cov txiaj ntsig tshuaj.​​ 

3. DHCS tau npaj li cas rau qhov ntim PA uas nce ntxiv, kev tsis lees txais cov lus thov, thiab qhov ntim ntawm lub chaw hu xov tooj uas cuam tshuam nrog Pediatric Integration?​​ 

Zoo ib yam li cov neeg laus rov qab los, qhov kev tsim ntawm Pediatric Integration yog ib qho kev siv zog ntawm cov ntaub ntawv uas tau pib nrog kev txheeb xyuas cov ntaub ntawv keeb kwm thiab cov ntaub ntawv PA. Hauv kev koom tes nrog cov neeg muaj feem cuam tshuam, DHCS tau txheeb xyuas cov hauv kev los txo cov kev tswj hwm kev ua haujlwm cuam tshuam nrog PA kev xa tawm los ntawm kev ntxiv cov tshuaj tsom rau menyuam yaus thiab cov khoom lag luam rau Daim Ntawv Cog Lus Tshuaj (CDL) thiab Cov Khoom Muag Khoom Muag; ua raws Medi-Cal thiab CCS cov txheej txheem kho mob; thiab pib txoj cai CCS Panel Provider Authority. [Lub Ib Hlis Ntuj thaum ntxov, DHCS tau kho nws txoj cai txoj hauv kev rau kev siv PI, raws li tau piav qhia ntau ntxiv hauv nqe lus nug #1 saum toj no.]​​ 

4. DHCS tau npaj cov kws kho mob thiab cov khw muag tshuaj li cas rau kev hloov pauv Pediatric Integration uas tshwm sim rau lub Ib Hlis 31, 2025?​​ 

Zoo ib yam li cov neeg laus rov qab los, DHCS tau ua ntau txoj hauv kev rau Pediatric Integration nthuav tawm thiab kev kawm, uas suav nrog cov hauv qab no:​​ 

  • Tshaj tawm peb tsab ntawv ceeb toom ua ntej, raws li hauv qab no:​​ 
    • 90-hnub ceeb toom rau Lub Kaum Hli 31, 2024​​ 
    • 60-hnub ceeb toom rau lub Kaum Ib Hlis 27, 2024​​ 
    • 30-hnub ceeb toom rau lub Kaum Ob Hlis 31, 2024​​ 
  • Posting Pediatric Integration resource materials on DHCS’ Medi-Cal Rx website under “Education and Outreach”.​​ 
  • Muab kev nthuav qhia nyob, sib tham sib txuas lus pib thaum lub Kaum Ib Hlis thiab txuas ntxiv mus txog rau lub Ib Hlis rau cov pab pawg neeg tseem ceeb thiab cov koom haum hauv zej zog menyuam yaus uas sawv cev rau cov tsev kho mob menyuam yaus, cov phiaj xwm kev saib xyuas, cov koom haum kws kho mob, cov neeg tawm tswv yim, thiab cov neeg uas pabcuam cov pej xeem no.​​ 
    • Thov nco ntsoov tias cov lus tawm tswv yim los ntawm cov koom nrog hauv webinars tau siv los ntawm DHCS los qhia txog kev txhim kho cov peev txheej kev kawm.​​ 
  • Kev npaj rau lub webinars txhua lub limtiam uas tuav los ntawm Medi-Cal Rx, pib thaum nruab nrab Lub Ib Hlis, los tshuaj xyuas cov cai thiab cov txheej txheem rau kev xa daim ntawv thov tshuaj thiab PA thov rau cov tswvcuab menyuam yaus.​​ 
  • Npaj los tuav lub sijhawm ua haujlwm rau Medi-Cal Rx Pediatric Integration thaum Lub Ib Hlis 2025 los teb cov lus nug tshwj xeeb uas ua rau mus nyob.​​ 
  • Muab los npaj thiab teem caij rau kev pab cuam/kev txhawb nqa rau tus kheej raws li qhov kev thov ntawm pawg neeg koom tes.​​ 
  • Siv Medi-Cal Rx Cov Neeg Siv Khoom Hauv Chaw Pabcuam (CSC) cov neeg sawv cev ntxiv los pab daws qhov kev hu xov tooj ntau ntxiv thiab teb cov lus nug.​​ 

5. Kuv tuaj yeem kawm paub ntxiv txog Rx Pediatric Integration qhov twg?​​ 

Yog xav paub ntxiv txog Pediatric Integration, suav nrog yuav ua li cas thiaj tau txais kev pab/kev txhawb nqa tus kheej, thov mus saib DHCS' Medi-Cal Rx lub vev xaib. Hauv qab nplooj ntawv Kev Kawm thiab Kev Nthuav Tawm, koj yuav pom ib daim tab Kev Koom Tes Nrog Menyuam Yaus nrog cov kev sib txuas mus rau cov ntaub ntawv tseem ceeb thiab cov ntaub ntawv hais txog cov webinars, cov yeeb yaj kiab kaw, thiab lwm yam ntaub ntawv txhawb nqa.​​ 

6. Cov chaw muab tshuaj yuav tsum them nqi li cas rau cov tswv cuab Medi-Cal thiab CCS (cov menyuam mos) uas tsim nyog rau CCS uas tseem tsis tau muaj lawv tus lej cim tswv cuab (ID) Medi-Cal?​​ 

Rau cov tswv cuab uas tsim nyog rau Medi-Cal thiab CCS (cov menyuam mos tshiab) uas tsis muaj lawv tus kheej daim ID tswv cuab Medi-Cal, cov kws muab tshuaj yuav tsum xa cov ntawv thov rau txhua qhov txiaj ntsig Medi-Cal Rx hauv qab tus lej ID ntawm tus tswv cuab Medi-Cal (tus menyuam mos tshiab). Qhov no tuaj yeem tshwm sim txog li 60 hnub tom qab yug los, thiab tom qab ntawd txhua qhov kev thov yuav tsum tau xa nrog tus lej ID ntawm tus tswv cuab Medi-Cal (tus menyuam mos). Cov kev thov rau cov menyuam mos yuav raug txheeb xyuas los ntawm Txoj Cai Kev Sib Raug Zoo thiab PA Hom Code (PATC). Tus nqi xa ntawm '03' - Tus neeg nyob ntawm koj thiab tus nqi PATC ntawm '8' yuav txheeb xyuas tus tswv cuab ua tus menyuam mos hauv daim ntawv thov. Yog tias lub tsev muag tshuaj txheeb xyuas qhov kev thov raws li tus menyuam mos, txoj cai ntawm CCS Panel Provider Authority yuav siv thiab qhov kev thov yuav raug ua tiav nrog tus menyuam hnub nyoog qis dua ib (1) xyoos. Yog tias daim ntawv thov tsis raug txheeb xyuas kom raug tias yog menyuam mos, daim ntawv thov yuav raug ua tiav los ntawm kev siv hnub nyoog ntawm leej niam.​​ 

Yuav Tsum Tau Tso Cai Ua Ntej​​ 

7. Thaum twg cov chaw muab tshuaj thiab cov kws sau ntawv thiaj li pib xa cov PA rau Medi-Cal thiab cov tswv cuab uas tsim nyog rau CCS hnub nyoog qis dua 22 xyoos mus rau Medi-Cal Rx?​​ 

Pib txij Lub Ib Hlis 31, cov chaw muag tshuaj tuaj yeem xa tuaj PAs ua haujlwm, txog li 100-hnub ua ntej hnub pib ntawm daim ntawv tshuaj tshiab lossis hnub sau ntawm daim ntawv tshuaj kho dua lossis rov ua dua uas yuav tsum tau muaj PA, tshwj tsis yog rau Medi-Cal thiab CCS-cov tswvcuab tsim nyog muaj hnub nyoog qis dua ib (1) xyoo.​​ 

8. Vim li cas cov PAs uas tau npaj ua ntej thiaj tsis raug lees txais rau cov tswv cuab uas tsim nyog rau Medi-Cal thiab CCS uas hnub nyoog qis dua (ib) xyoos?​​ 

Vim muaj kev hloov pauv sai sai hauv tus tswv cuab uas tsim nyog tau txais Medi-Cal lossis CCS txoj kev noj qab haus huv, PA cov lus thov rau cov tshuaj, cov khoom noj khoom haus hauv plab, thiab cov khoom siv kho mob rau cov tswv cuab uas tsim nyog tau txais Medi-Cal lossis CCS uas hnub nyoog qis dua ib (1) xyoos yuav tsum xa thaum lub sijhawm xav tau daim ntawv yuav tshuaj. Cov Kws Kho Mob thiab CNPs uas tau raug xaiv los ntawm CCS tsis raug rau qhov kev txwv hnub nyoog no thiab tuaj yeem sau ntawv rau Medi-Cal thiab cov tswv cuab uas tsim nyog rau CCS hnub nyoog qis dua ib (1) xyoos yam tsis tas yuav xa daim ntawv PA, raws li txoj cai ntawm Pawg Neeg Muab Kev Pabcuam ntawm CCS. Thov nco ntsoov tias cov tshuaj thiab cov khoom lag luam uas tsis suav nrog CCS Panel Provider Authority yuav xav tau PA, tsis hais tus tswv cuab hnub nyoog li cas los xij.​​ 

9. Vim li cas cov kev thov PA thiab kev hloov kho/kev tswj hwm UM thiaj li tsim nyog rau cov tswv cuab tsim nyog ntawm CCS yog tias kev kho mob tau raug tso cai rau tus mob tsim nyog ntawm CCS?​​ 

Kev tswj hwm UM, suav nrog PAs, yog qhov tsim nyog rau Medi-Cal thiab CCS-tsim nyog rau kev nyab xeeb thiab kev ncaj ncees ntawm cov kev pab cuam. DHCS tau ua haujlwm hnyav los txhim kho kev sib koom tes thiab txo cov nra hnyav ntawm kev tswj hwm los ntawm kev sib phim cov qauv kho mob Medi-Cal thiab CCS, ntxiv cov khoom lag luam tsom mus rau menyuam yaus rau CDL thiab Cov Khoom Lag Luam Uas Tau Them, thiab ua tiav CCS Panel Provider Authority. Kev saib xyuas PA ntawm cov tshuaj uas tau sau tseg, cov khoom siv kho mob thiab cov khoom siv hauv plab muab ib txheej ntxiv ntawm kev nyab xeeb, kev ua tau zoo, qhov xav tau tseem ceeb, tus nqi, thiab kev siv tsis raug, raws li tau teev tseg hauv Welfare and Institutions Code ntu 14105.39 thiab Title 22, California Code of Regulations, ntu 51313.6, hauv cov xwm txheej uas kev siv poob sab nraud ntawm cov kev xav tau suav nrog, tab sis tsis txwv rau Federal Food and Drug Administration cov lus qhia thiab cov qauv kev coj ua hauv zej zog.​​ 

10. Yog tias ib tug menyuam yaus uas tsim nyog tau txais Medi-Cal lossis CCS tab tom raug tso tawm hauv tsev kho mob, cov tshuaj puas yuav tsum tau xa mus rau PA?​​ 

Cov kev cai xa PA rau cov menyuam yaus Medi-Cal thiab cov tswv cuab tsim nyog CCS yog tsav los ntawm ntau yam suav nrog, tab sis tsis txwv rau, seb tus kws sau ntawv puas muaj CCS Panel Provider Authority, seb cov tshuaj puas suav nrog hauv qab Lub Chaw Haujlwm ntawd, thiab qhov kev pab cuam ntawm kev them nqi. Cov yam ntxiv xws li UM kev hloov kho / kev tswj hwm suav nrog qhov ntau thiab zaus txwv kuj tseem yuav cuam tshuam rau seb puas xav tau PA. [Thov saib cov lus teb #1 saum toj no kom paub ntxiv txog DHCS txoj cai hloov kho rau kev kho mob/kev sau tshuaj uas tej zaum yuav tsis xav tau PA txij li Lub Ib Hlis 31, 2025.]​​ 

11. Daim ntawv teev cov tshuaj thiab cov khoom lag luam uas tsis suav nrog hauv CCS Panel Provider Authority nyob qhov twg?​​ 

Cov tshuaj thiab cov khoom uas tsis suav nrog CCS Pawg Neeg Muab Kev Pabcuam raug txheeb xyuas nyob rau hauv Medi-Cal Rx Pom Zoo Cov Tshuaj Hauv Tebchaws (NDC) Daim Ntawv Teev Npe. Thawj qhov kev tshaj tawm nrog cov ntaub ntawv no yuav muaj ua ntej Lub Ib Hlis 31, 2025, nrog cov kev hloov tshiab txhua hli luam tawm thaum pib ntawm txhua lub hlis pib thaum Lub Ob Hlis.​​ 

Qhia​​ 

12. DHCS tau qhia tias yuav muaj kev saib xyuas sab hauv txhua peb lub hlis. Thov DHCS piav qhia seb lub hom phiaj thiab lub hom phiaj tseem ceeb puas tau thiab seb cov ntaub ntawv no puas yuav raug tshaj tawm rau pej xeem?​​ 

Lub hom phiaj ntawm DHCS qhov kev saib xyuas ntxiv txhua peb lub hlis, uas yuav tsuas yog sab hauv xwb thiab tsis tshaj tawm rau pej xeem, yog kom sau cov ntaub ntawv thov thiab PA tsis tu ncua. Cov ntaub ntawv no yuav raug siv los ntawm DHCS los sau cov ntaub ntawv thiab ua cov kev hloov pauv raws li cov ntaub ntawv, yog tias tsim nyog, rau cov txiaj ntsig ntawm Medi-Cal Rx tshuaj thiab CCS Panel Provider Authority txoj cai.​​ 

13. DHCS puas yuav tso tawm cov ntaub ntawv rau pej xeem los qhia txog qhov cuam tshuam ntawm Kev Koom Tes Nrog Menyuam Yaus?​​ 

Zoo ib yam li kev tshaj tawm tawm tom qab txhua qhov kev ua tiav rau cov neeg laus rov qab los, DHCS yuav tshaj tawm tsab ntawv tshaj tawm txhua lub limtiam uas suav nrog cov ntaub ntawv ntawm qhov ntim ntawm kev thov, PAs, thiab hu rau Medi-Cal Rx CSC. DHCS txhawb kev pom meej hauv cov txheej txheem no thiab tau cog lus ua haujlwm ze nrog cov neeg muaj feem cuam tshuam uas muaj lus nug tshwj xeeb thiab / lossis kev txhawj xeeb.​​ 

Kev Noj Qab Haus Huv​​ 

14. Kev Siv Pediatric Integration puas cuam tshuam rau cov khoom noj khoom haus hauv plab?​​ 

Yog lawm, qhov rov qab kho dua ntawm UM kho / tswj, suav nrog kev hloov kho kom muaj nuj nqis thiab PA cov cai, nyob rau hauv Pediatric Integration siv rau txhua qhov kev pab cuam hauv khw muag tshuaj Medi-Cal Rx.​​ 

15. Puas yog CCS Panel Provider Authority siv rau cov khoom noj khoom haus hauv plab?​​ 

CCS Panel Provider Authority siv rau tag nrho cov khoom noj khoom haus uas tau cog lus hauv cov khoom noj uas muaj calorie ntau tshaj txhua hnub. Cov khoom noj khoom haus uas tsis tau cog lus nkag mus rau hauv cov khoom noj khoom haus thiab cov khoom noj khoom haus nkag mus rau sab nraud uas tsim los siv tsis suav nrog Txoj Cai no.​​ 

16. Tus kws kho mob puas yuav tsum tau txais PA hloov tshiab rau lwm yam khoom noj khoom haus thaum cov khoom qab zib hauv PA raug txiav txim rov qab thiab nws yog tib yam khoom?​​ 

Txoj cai tswjfwm kev noj zaub mov nkag mus tso cai rau kev sib pauv ntawm cov khoom noj khoom haus uas tau cog lus rau hauv tib yam khoom / hom. Yog xav paub ntxiv txog cov khoom lag luam tsis txaus thiab kev hloov pauv ntawm cov khoom lag luam, thov mus rau Medi-Cal Rx Tus Kws Kho Mob Phau Ntawv Qhia Ntu 12.8 thiab Medi-Cal Rx Cov Lus Nug Nug Txog Cov Khoom Noj Khoom Noj.​​ 

17. DHCS tau tsim cov kev txwv rau cov khoom noj khoom haus hauv plab li cas?​​ 

Cov kev txwv ntawm cov khoom noj khoom haus uas noj tau yog raws li cov lus qhia uas tau tshaj tawm, suav nrog cov lus qhia txog Khoom Noj Khoom Haus hauv tebchaws, uas tau raug tshuaj xyuas los ntawm DHCS thiab suav nrog hauv txoj cai Medi-Cal Rx uas tau tshaj tawm. Cov kev thov uas tau xa rau cov nqi uas tshaj qhov txwv ntawm txoj cai uas tau tshaj tawm tuaj yeem pom zoo nrog daim ntawv thov PA uas qhia txog qhov tsim nyog kho mob. Cov kev thov PA raug tshuaj xyuas los ntawm Medi-Cal Rx thiab cov lus teb xa mus rau tus neeg xa ntawv hauv 24 teev. Yog tias tsis tuaj yeem tsim kom muaj kev tsim nyog kho mob rau qhov ntau npaum li cas uas tau thov, Medi-Cal Rx yuav muaj peev xwm pom zoo rau qhov kev thov nrog kev hloov kho uas cuam tshuam rau cov menyuam yaus Medi-Cal lossis tus tswv cuab tsim nyog CCS cov kev xav tau calorie txhua hnub thiab lwm yam kev txiav txim siab kho mob uas yuav siv tau. Lub sijhawm no, tus menyuam yaus uas tsim nyog tau txais Medi-Cal lossis CCS yuav tau txais cov mis uas xav tau hauv cov kev txwv calorie. Cov ntaub ntawv ntxiv txog Kev Txwv Kev Muab Khoom Noj Khoom Haus Hauv Qhov Ncauj tuaj yeem pom nyob rau hauv Tshooj 12.6 ntawm Phau Ntawv Qhia Txog Kev Muab Tshuaj Medi-Cal Rx. Cov kev txwv ntau tshaj plaws rau txhua yam khoom rau 31 hnub tau muab luam tawm rau ntawm Daim Ntawv Teev Npe ntawm Cov Khoom Noj Khoom Haus Hauv Plab.​​ 

thov​​ 

18. Puas yog qhov kev hloov pauv thaum muaj xwm txheej ceev 14 hnub tseem yuav siv tau thaum lub sijhawm Medi-Cal Rx Pediatric Integration?​​ 

Yog lawm, cov chaw muab tshuaj muaj peev xwm siv 14-hnub kev kho mob xwm txheej ceev los xyuas kom meej tias cov neeg mob Medi-Cal lossis CCS-cov tswv cuab tsim nyog tau txais cov nyiaj pab hauv tsev muag tshuaj raws sijhawm. Medi-Cal Rx Pediatric Integration tsis muaj kev cuam tshuam rau txoj cai no.​​ 

CCS Panel Provider Enrollment​​ 

19. Kuv yog ib tus neeg muab kev pabcuam CNP thiab CCS. Lawv hais rau kuv tias kuv yuav tsum xa daim ntawv PA rau cov tshuaj uas tsis tas yuav tsum muaj PA rau CCS Paneled Providers. Vim li cas ho yog li ntawd?​​ 

Yog tias koj tau thov los ua CCS Paneled Provider ua ntej Lub Kaum Hli 2023, koj raug xaiv los ua Tus Kws Saib Xyuas Neeg Mob (RN) thaum lub sijhawm ntawd. Yuav kom tsim nyog rau CCS Vaj Huam Sib Luag Muab Kev Tso Cai ua CNP, koj yuav tsum tau sau npe ua CNP. Txhawm rau txheeb xyuas tus neeg muab kev pabcuam thiab/lossis xa daim ntawv thov CCS tshiab, thov mus saib ntawm CCS Panel Application webpage.​​ 

20. Kuv yog ib tug kws kho mob uas tau sau npe rau Medi-Cal tab sis tam sim no kuv tsis yog ib tug kws kho mob hauv pawg CCS. Kuv puas tuaj yeem thov rau CCS Panel status?​​ 

Yog lawm, cov kws kho mob uas kho CCS cov tswv cuab tsim nyog tau raug txhawb kom thov rau CCS Panel Status. Cov lus nug txog kev tsim nyog thiab cov txheej txheem thov tuaj yeem xa mus rau ProviderPaneling@dhcs.ca.gov. CCS Panel raws li txoj cai tsis txwv rau cov kws kho mob thiab CNPs; Txawm li cas los xij, CCS Pawg Neeg Saib Xyuas Kev Ua Haujlwm uas tso cai rau cov kws sau ntawv sau ntawv rau feem ntau cov tshuaj thiab cov khoom muag tshuaj rau menyuam yaus Medi-Cal lossis CCS cov tswvcuab tsim nyog yam tsis tau xa daim PA yog txwv rau cov kws kho mob thiab CNPs. Yog xav paub ntxiv txog CCS Paneling, thov mus saib ntawm DHCS lub vev xaib Ua Tus Muab CCS.​​ 

21. Kuv puas tsim nyog tau txais CCS Panel Provider Authority yog tias kuv tsis yog CCS Panel Provider?​​ 

Yuav kom tsim nyog rau CCS Panel Provider Authority, cov kws kho mob yuav tsum yog Medi-Cal tus kws kho mob sau npe thiab sau npe CCS Panel Provider. Tam sim no, tsuas yog cov kws kho mob thiab CNPs tsim nyog rau CCS Panel Provider Authority.​​ 

22. Vim li cas CCS Pan Provider Authority tsuas yog siv rau cov menyuam yaus hnub nyoog 20 xyoo thiab qis dua xwb?​​ 

Cov neeg laus rov qab los siv rau Medi-Cal cov tswv cuab hnub nyoog 22 xyoos thiab laus dua. Pediatric Integration siv rau menyuam yaus Medi-Cal thiab CCS-cov tswv cuab tsim nyog 21 thiab qis dua. Thaum lub sij hawm rov qab los rau cov neeg laus, lub xyoo kev tshav ntuj ntxiv ib ntus tau ntxiv rau UM kho/tswj rau cov menyuam yaus rau Medi-Cal thiab CCS-cov tswv cuab tsim nyog uas muaj hnub nyoog 21 xyoos. Cov menyuam yaus uas tau teev tseg rau Medi-Cal thiab CCS-cov tswvcuab tsim nyog muaj hnub nyoog qis dua 21 xyoos, ua raws li tsoomfwv cov cai kuaj ntxov ntxov thiab sijhawm sijhawm, kuaj mob, thiab kho (EPSDT).​​