Managed Care Plan County Model Change Information
County Model Hloov rau 2024 Medi-Cal Managed Care Plan Procurement
Xyoo 2021, DHCS tau pib txheej txheem kev yuav khoom thoob plaws xeev ntawm kev lag luam Medi-Cal cov phiaj xwm tswj hwm kev saib xyuas (MCPs) rau MCP daim ntawv cog lus tshiab pib txij Lub Ib Hlis 1, 2024. Lub nroog muaj lub cib fim los hloov cov qauv kev npaj saib xyuas kev tswj xyuas uas ua haujlwm hauv lawv lub nroog.
If a county transitions to a model that includes a local plan, DHCS may remove that county from the commercial plan procurement (for a single local plan model) or reduce the number of commercial plans procured in the county (for a Two-Plan Model). Counties interested in shifting to a local plan model through an arrangement with an existing managed care plan or the formation of a new local plan independent of an existing managed care plan, were asked through the County Managed Care Transition to Local Plan: Letter of Intent Instructions to submit their Letter of Intent by April 30, 2021.
Raws li tau piav nyob rau hauv Tsab Ntawv Qhia Txog Kev Npaj Siab, DHCS muaj txoj cai los txiav txim seb qhov twg, thiab pes tsawg, cov phiaj xwm saib xyuas (MCPs) uas Lub Xeev cog lus rau cov kev pabcuam Medi-Cal hauv cov nroog. Kev txiav txim siab ntawm DHCS thaum kawg yog coj los ntawm cov txiaj ntsig zoo tshaj plaws ntawm Medi-Cal cov neeg tau txais txiaj ntsig thiab lub xeev cov hom phiaj rau Medi-Cal tswj kev saib xyuas kev noj qab haus huv raws li CalAIM, uas yog los txhawb kev txhim kho kev saib xyuas zoo, ua kom yooj yim dua thiab txo qhov nyuaj, thiab txhim kho tag nrho cov kev saib xyuas tib neeg.
Kev ntsuam xyuas DHCS suav nrog kev txheeb xyuas keeb kwm ntawm kev saib xyuas zoo thiab kev noj qab haus huv nyiaj txiag thiab kev muaj peev xwm ntawm lub koom haum. Cov neeg thov uas DHCS pom zoo raws li kev pom zoo txav mus rau theem tom ntej ntawm cov txheej txheem kev ntsuas raws li tau teev tseg hauv Tus Qauv Hloov Sijhawm. Kev txiav txim zaum kawg yuav yog nyob ntawm MCP kev npaj ua haujlwm thiab kev pom zoo CMS.
Cov npe hauv qab no yog cov peev txheej nrog cov ntaub ntawv tseem ceeb hais txog tus qauv hloov pauv nrog rau daim ntawv cog lus ncaj qha nrog cov phiaj xwm saib xyuas tau pib txij Lub Ib Hlis 1, 2024:
- Medi-Cal Tswj Kev Pabcuam Kev Muag Khoom thiab Hloov Kho Daim Ntawv Cog Lus
- Managed Care Plan County Tus Qauv Hloov Hloov Hloov Tshiab 12/07/2021
- Managed Care Plan County Model Change Update – Conditional Approval Status
- County Managed Care Transition to Local Plan: Tsab Ntawv Qhia Txog Lub Hom Phiaj
- County Plan Model Hloov Sijhawm
- County Managed Care Transition Network Strategy Guidance
Raws li cov peev txheej ntxiv muaj, nplooj ntawv no yuav hloov kho.