Cov lus nug nquag nug los ntawm Cov Neeg Koom Tes Hauv Lub Rooj Hais Plaub​​  

Cuaj hlis 30, 2025​​ 

Hauv qab no yog cov lus teb rau feem ntau ntawm cov lus nug uas Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS) tau txais thaum lub rooj sib hais ntawm cov koom nrog rau lub Cuaj Hlis 30, 2025. Yog tias koj tsis pom cov lus teb rau koj cov lus nug, thov xa email mus rau qhov chaw nyob email uas tsim nyog tau teev tseg hauv qab no:​​ 

• Yog muaj lus nug txog kev sau npe rau cov neeg muab kev pab, thov hu rau dhcspedstakeholder@dhcs.ca.gov​​ 

• Yog koj muaj lus nug txog cov txiaj ntsig Medi-Cal dav dav, thov hu rau peb.​​  Medi-Cal.Benefits@dhcs.ca.gov.​​  

• Yog koj muaj lus nug txog Managed Care, thov hu rau MCQMD@dhcs.ca.gov.​​ 

Kev tso npe rau tus kws kho mob​​ 

1. Puas muaj kev hloov pauv rau Qualified Autism Service (QAS) cov koom haum uas tsuas muaj qhov chaw tswj hwm thiab tsis pom cov neeg mob hauv ib lub chaw kho mob, thiab hauv zej zog nkaus xwb?​​  

Tsis muaj kev hloov pauv rau cov kev cai rau QAS cov koom haum muab kev pabcuam uas muaj ntau tshaj li ib tus neeg muab kev pabcuam QAS thiab npaj siab yuav sau nqi rau QAS cov kws tshaj lij thiab cov kws tshaj lij. Pib txij lub Kaum Ib Hlis Ntuj 17, 2025, DHCS tsuas yog hloov kho Medi-Cal cov kev cai rau npe nkag thiab cov txheej txheem tshwj xeeb rau cov neeg thov QAS uas muaj xws li Board-Certified Behavioral Analyst (BCBA) uas tsuas yog them nqi Medi-Cal rau lawv tus kheej xwb.​​ 

2. Yog tias kuv yog ib tug tshiab QAS tus muab BCBA, kuv puas yuav tsum tau tos kom txog thaum lub Kaum Ib Hlis 17, 2025 rau npe rau kuv tus kheej lossis kuv puas tuaj yeem tau txais daim ntawv pov thawj ua ntej lub Kaum Ib Hlis 17, 2025?​​  

Cov chaw zov me nyuam uas tsis tau tso npe tam sim no thiab tsis tam sim no muaj txoj hauv kev rau npe, xws li BCBAs ib tus neeg uas tsis muab kev pabcuam tus kheej ntawm lawv qhov chaw nyob, yuav tsim nyog rau npe thaum daim ntawv tshaj tawm pib siv rau lub Kaum Ib Hlis 17, 2025. Yog tias ib tus neeg BCBA muab kev pabcuam ntawm lub tsev kho mob lossis lwm qhov chaw uas ua tau raws li txhua qhov chaw tsim khoom lag luam, lawv yuav tsim nyog rau npe ua ntej lub Kaum Ib Hlis 17, 2025.​​  

3. Peb puas yuav tshem tag nrho QAS cov kws tshaj lij uas peb tau xa tuaj rau hauv PAVE?​​  

Tsis yog, DHCS tsis pom zoo kom tshem tawm tag nrho cov kws tshaj lij QAS uas tau tshaj tawm yav dhau los thiab cov kws tshaj lij los ntawm koj daim ntawv thov sau npe ua ntej. Thov nco ntsoov tias pib txij lub Kaum Ib Hlis 17, 2025, koj yuav tsis tas yuav tsum tshaj tawm lossis hloov kho cov ntaub ntawv no txhua 35 hnub raws li California Txoj Cai Tswjfwm Ntiag Tug (CCR), Title 22, Tshooj 51000.40.​​ 

4. Puas yog Medi-Cal Cov Kev Npaj Khomob xav kom muaj kev lees paub Medi-Cal rau npe rau QAS cov chaw muab kev pabcuam kev coj tus cwj pwm? Yog tias muaj, DHCS yuav cia siab tias cov phiaj xwm yuav siv tau li cas yog QAS cov chaw muab kev pabcuam tsis raug ntxiv rau hauv daim ntawv thov E-daim ntawv?​​  

Cov neeg muab kev pab yuav tau txais tsab ntawv pom zoo hauv PAVE thaum lawv daim ntawv thov raug pom zoo. Cov neeg muab kev pabcuam them nqi rau kev pabcuam (FFS) uas tau sau npe yuav raug suav nrog rau hauv Medi-Cal Open Data Portal. Thaum ib lub koom haum muab kev pab cuam QAS sau npe los them nqi rau cov neeg muab kev pab cuam QAS, cov kws tshaj lij QAS, thiab cov kws pab tswv yim QAS, cov neeg no lawv tus kheej tsis tau sau npe rau hauv Medi-Cal los them nqi ncaj qha thiab yog li ntawd yuav tsis raug lees paub tias yog ib tus neeg muab kev pab cuam Medi-Cal uas tau sau npe. Tsuas yog lub koom haum muab kev pabcuam QAS uas tau sau npe xwb thiaj li yuav raug sau npe. Ua ntej tsab ntawv xov xwm no, cov phiaj xwm kev saib xyuas kev noj qab haus huv tsuas yog tuaj yeem lees paub tias lub koom haum QAS tau sau npe rau hauv Medi-Cal - qhov ntawd tseem tsis tau hloov pauv.​​ 

5. Pib lub Kaum Ib Hlis Ntuj 17, 2025, rau lub koom haum QAS rau npe, peb yuav tsis tas yuav tsum tau sau npe ib qho ntawm peb cov kws kho mob QAS, cov kws tshaj lij, lossis cov kws tshaj lij?​​ 

Pib txij lub Kaum Ib Hlis Ntuj 17, 2025, Cov neeg thov kev pab QAS yuav tsis tas yuav tsum tau tshaj tawm txhua tus QAS tus kws kho mob, kws tshaj lij, lossis tus kws tshaj lij uas lawv npaj siab yuav sau nqi hauv lawv daim ntawv thov npe Medi-Cal. Hloov chaw, QAS cov koom haum muab kev pabcuam yuav raug tso cai los ua pov thawj txog qhov tsim nyog ntawm cov neeg no. Lawv yuav tsum tuav ib daim ntawv teev npe sab hauv uas muaj xws li:​​ 

• National Provider Identifier (NPI)​​ 
• Lub npe​​ 
• Txhua daim ntawv tso cai, ntawv pov thawj, lossis tus lej sau npe​​ 

Daim ntawv teev npe no yuav tsum muaj rau DHCS raws li kev thov lossis thaum lub sijhawm kuaj xyuas thiab yuav tsis tas yuav xa los ntawm PAVE system ua ib feem ntawm cov txheej txheem rau npe.​​ 

6. Puas yog QAS cov kws tshaj lij & cov kws tshaj lij muab kev pabcuam xav tau txhua yam xa tuaj thaum lawv koom nrog ib pab pawg uas twb tau tso npe lawm?​​ 

Tsis yog, txawm li cas los xij, QAS cov koom haum muab kev pabcuam yuav tsum tau khaws qee cov ntaub ntawv rau txhua tus kws kho mob uas lawv npaj siab yuav sau nqi Medi-Cal qhov kev pab cuam. Thov saib cov lus teb rau lo lus nug #5 kom paub ntau ntxiv.​​ 

7. Daim ntawv nthuav qhia tau hais tias koj yuav tsum muab cov ntaub ntawv BCBA raws li kev thov. Thaum twg cov kev thov no raug tsim? Puas muaj qee yam tshwj xeeb ua rau qhov ntawd?​​  

The QAS provider organization must maintain, at a minimum, and make available the following information for DHCS’ review upon request for each QAS provider, QAS professional, and QAS paraprofessional: NPI, first and last name, and any applicable professional license number, certification number, or registration number of the QAS providers providing behavioral health treatment services. DHCS reserves the right to audit or request records from the provider pursuant to state and federal law and the provider agreement.​​ 

8. Koj puas tuaj yeem lees paub tias Medi-Cal MCPs tsis tas yuav tsum tau kuaj xyuas Medi-Cal rau npe rau BCBAs?​​  

Medi-Cal Managed Care Plans (MCPs) yuav tsum tau lees paub rau npe rau cov kws kho mob uas tsim nyog rau npe rau cov nqi-rau-kev pabcuam Medi-Cal. Pib txij lub Kaum Ib Hlis Ntuj 17, 2025, DHCS yuav pib lees txais cov ntawv sau npe los ntawm ib tus neeg BCBAs uas ua haujlwm los ntawm lawv qhov chaw nyob lossis lwm qhov chaw tswj hwm thiab tsis muab kev pabcuam lub cev los ntawm qhov chaw nyob no.​​ 

9. Puas muaj hnub kawg tshiab rau kev tso npe Medi-Cal lossis txhua lub koom haum puas yuav tsum tau tso npe ua ntej lub Kaum Ib Hlis 1, 2025?​​  

Tsis yog, tsis muaj hnub kawg rau kev sau npe rau hauv Medi-Cal uas them tus nqi rau kev pabcuam. Yog tias koj muaj daim ntawv cog lus nrog lossis npaj siab yuav cog lus nrog Medi-Cal managed care plan (MCP), thov xa cov lus nug txog cov kev cai pov thawj los ntawm cov phiaj xwm ncaj qha mus rau cov phiaj xwm uas koj muaj daim ntawv cog lus lossis npaj siab yuav cog lus rau. Daim ntawv teev npe Medi-Cal Managed Care Plan muaj cov ntaub ntawv tiv tauj rau txhua txoj kev npaj.​​  

10. Puas yog lub hom phiaj los txhawb cov neeg ua haujlwm solo pib, thaum tuav cov pab pawg kom muaj cov txheej txheem siab dua? Txoj cai yuav nthuav dav mus rau cov pab pawg, lossis puas yog qhov kev sib txawv no txhais tau tias nyob ruaj khov?​​  

Qhov kev zam tsuas yog siv rau ib tus neeg BCBAs uas tso npe nkaus xwb los sau nqi rau cov kev pabcuam uas lawv tus kheej xa tuaj yam tsis muaj chaw tsim khoom lag luam (EPOB). DHCS tau cog lus los txuas ntxiv cov neeg koom nrog kev koom tes thiab kev sib tham tab sis yuav tsum ua raws li tsoomfwv thiab lub xeev cov txheej txheem kev ncaj ncees, suav nrog cov txheej txheem tiv thaiv kev dag uas cuam tshuam nrog kev koom nrog kev tso npe nkag.​​  

11. Cov koom haum non-profit puas tuaj yeem thov kev zam?​​ 

Cov kws kho mob QAS tuaj yeem tso npe ua ib lub koom haum tsis muaj txiaj ntsig vim tsis muaj kev txwv rau hom kev lag luam uas tuaj yeem tso npe raws li hom kev lag luam kho mob. Txawm li cas los xij, yog tias koj npaj siab tso npe ua Lub Koom Haum Hauv Zej Zog (CBO) thiab sau nqi rau cov kev pabcuam kev noj qab haus huv ntawm tus cwj pwm, koj yuav tsum tau teeb tsa raws li 501(c)(3) lub koom haum tsis muaj txiaj ntsig thiab tsis muaj kev zam rau txoj hauv kev rau npe nkag. Yog xav paub ntxiv thov mus saib cov ntawv xov xwm no:​​ 

Hloov kho Medi-Cal Cov Cai Nkag Mus Kawm thiab Cov Txheej Txheem rau Cov Koom Haum Hauv Zej Zos, Cov Cai Saib Xyuas Kev Noj Qab Haus Huv Hauv Zos thiab Lub Nroog Cov Menyuam Yaus thiab Tsev Neeg Cov Cai​​ 

Hloov kho Medi-Cal Kev Nkag Mus Nkag Siab thiab Cov Txheej Txheem rau Cov Koom Haum Hauv Zej Zog, Lub Chaw Saib Xyuas Kev Noj Qab Haus Huv Hauv Zos, thiab Lub Nroog Cov Menyuam Yaus thiab Tsev Neeg Pawg Thawj Coj (Hloov kho rau lub Tsib Hlis 5, 2025 rau CBO Cov Chaw Muab Kev Pab Cuam Kev Noj Qab Haus Huv)​​  

Tsis tas li ntawd, yog tias koj npaj siab tso npe rau hauv ib txoj hauv kev rau hom kws kho mob, xws li Daim Ntawv Tso Cai Sib Yuav thiab Tsev Neeg Tus Kws Kho Mob lossis Tus Kws Kho Mob, ces koj yuav tsis tsim nyog rau npe los ua ib lub koom haum tsis muaj txiaj ntsig thiab yuav tsum tau tso npe rau hauv ib lub koom haum tshaj lij txhawm rau sau nqi Medi-Cal rau lawv cov kev pabcuam.​​   

12.   Under this policy, when an individual BCBA enrolls without a business address, are they expected to personally deliver all services (one-to-one, family training, supervision), or do they also bill for technician delivered services under their supervision? We’d like to better understand the reasoning to why the new policy allows individual BCBAs to enroll without a business address, but small group practices with only two or three BCBAs are still required to maintain one?​​ 

Tsis muaj kev hloov pauv rau cov kev cai uas twb muaj lawm rau QAS cov koom haum muab kev pabcuam uas tsim los ntawm ntau tus neeg muab kev pabcuam QAS uas npaj siab yuav sau nqi sawv cev ntawm QAS cov kws tshaj lij thiab cov kws tshaj lij. Cov koom haum no yuav tsum tau ua kom tau raws li tag nrho cov kev xav tau ntawm cov kev pab cuam.​​ 

DHCS tseem cog lus rau kev sib koom tes txuas ntxiv nrog cov neeg muaj feem cuam tshuam los kho cov cai hauv txoj hauv kev uas txhawb nqa cov kev xav tau ntawm QAS cov neeg muab kev pabcuam hauv zej zog. Cov lus teb tau txais yuav qhia ntxiv txog kev txhim kho txoj cai yav tom ntej.​​ 

13.   Rau lub koom haum QAS uas muaj QAS cov kws tshaj lij lossis cov kws tshaj lij uas lawv tau them nqi rau, lawv puas suav tias yog ib tus neeg thiab raug zam los ntawm qhov yuav tsum tau ua?​​ 

Tsis yog, cov kev hloov tshiab rau QAS cov ntawv tshaj tawm tsuas yog siv rau ib tus neeg BCBAs uas npaj siab tso npe rau daim nqi rau lawv tus kheej cov kev pabcuam thiab leej twg sau lawv qhov chaw nyob lossis lwm qhov chaw tsis yog chaw kho mob raws li lawv qhov chaw nyob. Cov tib neeg no raug zam los ntawm EPOB cov cai, vim lawv tsis muab kev pabcuam tus kheej ntawm qhov chaw ntawd.​​ 

Txawm li cas los xij, yog tias lub koom haum QAS npaj siab them nqi rau cov kev pabcuam uas ua los ntawm tus kws tshaj lij, txoj hauv kev rau npe nkag yuav tsis siv tau. Cov koom haum zoo li no yuav tsum ua raws li tus txheej txheem rau npe nkag thiab ua tau raws li txhua qhov kev xav tau.​​ 

14. Qhov sib txawv ntawm kev tso npe ua QAS lub koom haum lossis Lub Koom Haum Hauv Zej Zog (CBO) yog dab tsi?​​ 

QAS cov koom haum muab kev pabcuam thiab cov tib neeg tso npe rau hauv qhov kev pabcuam Medi-Cal kom them nqi rau cov kev pabcuam kev coj tus cwj pwm nkaus xwb.​​ 

Cov koom haum hauv zej zog (CBOs) tso npe rau hauv Medi-Cal qhov kev pab cuam los sau nqi rau cov neeg ua haujlwm noj qab haus huv hauv zej zog (CHW), kev tiv thaiv kab mob hawb pob (AP), kev ncaj ncees koom nrog (JI), thiab/lossis cov kev pabcuam kev noj qab haus huv.​​  

Kev them nqi​​ 

1. Peb puas tuaj yeem tau txais kev qhia meej ntxiv ntawm BCBAs cov nqi ntawm lawv tus kheej lossis peb puas tuaj yeem sau nqi hauv peb lub koom haum raws li peb twb tau ua lawm?​​ 

BCBAs tuaj yeem tso npe thiab sau nqi raws li ib tus neeg lossis ib lub koom haum.​​ 

2. Peb yog ib lub koom haum QAS, thiab txij li lub Kaum Ib Hlis 17, 2025, peb yuav tsis tas yuav ntxiv cov chaw muab kev pabcuam ntxiv lawm. Peb puas tseem yuav sau nqi raws li tus neeg muab kev pabcuam, lossis peb puas yuav them nqi raws li ib tus neeg muab kev pabcuam rau txhua qhov kev pabcuam?​​ 

Lub koom haum QAS nrog hom ob NPI yuav them nqi raws li hom ob NPI rau txhua qhov kev pabcuam.​​  

Cov peev txheej ntxiv​​ 

1. Vim li cas ib tus neeg muab kev pabcuam QAS tsuas yog muab cov txiaj ntsig rau cov tib neeg uas muaj autism xwb thaum cov txiaj ntsig tsis txwv rau cov tib neeg uas muaj autism?​​  

Kev kho mob kev noj qab haus huv ntawm tus cwj pwm tsis yog tsuas yog rau cov menyuam yaus uas muaj autism xwb thiab muaj rau txhua tus menyuam yaus Medi-Cal uas muaj hnub nyoog qis dua 21 xyoos uas tus kws kho mob lossis tus kws kho mob puas siab puas ntsws txiav txim siab tias nws yog qhov tsim nyog rau kev kho mob. Yog tias koj xav paub ntxiv txog cov kev pabcuam uas them rau hauv qhov txiaj ntsig no, thov xa email rau Benefits Division: MediCal.Benefits@dhcs.ca.gov.​​ 

2. Koj puas yuav xa PowerPoint no? Los yog cov ntaub ntawv no puas yuav nyob hauv lub vev xaib?​​  

Cov ntaubntawv kaw suab ntawm lub rooj sib hais pej xeem yuav raug tshaj tawm rau ntawm nplooj ntawv web ntawm cov ntawv xov xwm: https://www.dhcs.ca.gov/Pages/stakeholder-hearing-qas-providers-bhts.aspx​​ 

3.   Our MCO, CalOptima, states that we need to have our newly added BCBAs added to Medi-Cal PAVE. However, we can’t currently add to the application. How do we add new providers as BCBAs to the PAVE portal, as currently the account states no changes can be made?​​ 

Ua ntej lub Kaum Ib Hlis 17, 2025, koj yuav tuaj yeem hloov kho koj cov npe hauv daim ntawv thov; txawm li cas los xij, nws tsis tas yuav. Tom qab lub Kaum Ib Hlis 17, 2025, cov ntaub ntawv no yuav tsis tas yuav tsum tau muab tso rau hauv ib feem ntawm daim ntawv thov.​​  

If you’re having difficulty with your PAVE account, please email DHCSPEDstakeholder@dhcs.ca.gov and we can assist you.
​​ 

4. Peb yuav tau txais kev ceeb toom li cas yog tias tus kws kho mob QAS tsis raug lees paub nrog Medi-Cal?​​  

DHCS Tus Muab Kev Tso Npe Sau Npe tsis xa cov ntawv ceeb toom rau QAS tus kws kho mob Medi-Cal validation.​​ 

Koj tuaj yeem tshawb xyuas qhov xwm txheej rau cov chaw muab kev pabcuam Medi-Cal uas them tus nqi los ntawm kev mus rau Medi-Cal Open Data Portal.​​