Tsev Cov Kev Pabcuam Cov Kev Pabcuam Medi-Cal Qauv Nkag Mus Rau Kev Kho Mob Cell thiab Gene (CGT)-

Cell thiab Gene Therapy (CGT) Access Model-

Medi-Cal Cov Lus Nug Nug Txog Tus Tswv Cuab (FAQs)

Hloov kho Lub Yim Hli 1, 2025

Cov Lus Nug Nquag Nug nram qab no muab cov lus qhia ntxiv thiab kev piav qhia rau cov tswv cuab Medi-Cal txog tus qauv nkag mus rau CGT. Thaum Lub Chaw Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS) tau txais cov lus nug ntxiv, cov FAQ no yuav raug hloov kho tshiab. Yog xav paub ntxiv txog CGT Access Model, thov mus saib cov FAQs dav dav.

General

Kuv txoj kev kho mob CGT yuav zoo li cas hauv Medi-Cal's CGT Access Model?
Ib tug tswv cuab txoj kev taug kev tau txais kev kho mob CGT yuav suav nrog cov hauv qab no:

Kev sab laj nrog hematologists thiab lwm tus kws kho mob tshwj xeeb
Kev ntsuam xyuas tag nrho ntawm qhov chaw kho mob suav nrog kev xav tau ntawm lub cev, kev xav tau ntawm tus cwj pwm kev noj qab haus huv, thiab kev xav tau kev txhawb nqa kev sib raug zoo
Kev sib koom tes ntawm kev saib xyuas thiab kev pab txhawb nqa rau cov tswv cuab thiab tsev neeg taug txoj kev kho mob
Kev tswj kab mob hauv kev npaj rau CGT
Fertility preservation Services
Gene therapy infusion thiab kev pabcuam rov qab
Kev kho mob tom qab kev kho mob

How do I know which CGT SCD medication I will receive through Medi-Cal’s CGT Access Model?
Medi-Cal tus qauv nkag mus rau CGT yuav npog ob hom tshuaj CGT uas tau pom zoo los ntawm tsoomfwv Meskas Lub Chaw Haujlwm Saib Xyuas Khoom Noj thiab Tshuaj (FDA) rau kev kho mob sickle cell disease (SCD). Qhov no suav nrog, CASGEVY™, uas yog tsim los ntawm Vertex Pharmaceuticals, Inc., thiab LYFGENIA™, uas yog tsim los ntawm bluebird bio, Inc. Koj tus kws kho mob yuav txiav txim siab seb cov tshuaj CGT SCD twg zoo tshaj plaws rau koj tus kheej qhov xwm txheej thiab xa daim ntawv thov tsim nyog rau koj kom koj thiaj li koom nrog CGT Access Model thiab tau txais cov tshuaj CGT SCD.

Cov tshuaj CGT rau SCD puas tuaj yeem cuam tshuam rau kuv txoj kev xeeb tub (muaj peev xwm muaj menyuam)?
Yog, chemotherapy siv rau hauv kev hloov hlwb thaum lub sijhawm CGT kev kho mob yuav cuam tshuam rau koj qhov kev muaj menyuam (muaj peev xwm muaj menyuam). Txawm li cas los xij, vim yog qhov tseeb no, cov kev pabcuam tiv thaiv kev xeeb tub tau them thiab muaj rau cov tswv cuab raws li Medi-Cal's CGT Access Model. Koj raug txhawb kom tham txog cov kev xaiv tiv thaiv kev xeeb tub nrog koj tus kws kho mob thaum tau txais kev pom zoo tab sis ua ntej pib kho CGT. Thov saib ntu Cov Kev Pabcuam Nkag Mus Rau CGT, suav nrog Cov Kev Pabcuam Tiv Thaiv Kev Muaj Menyuam hauv cov FAQ no kom paub ntau ntxiv.

Kev tsim nyog

Kuv puas tsim nyog koom nrog Medi-Cal's CGT Access Model thiab tau txais cov tshuaj CGT SCD?
Medi-Cal cov tswv cuab yuav tsum ua tau raws li txhua yam hauv qab no:

Muaj cov ntaub ntawv kho mob ntawm SCD;
Nkag mus rau npe rau hauv Medi-Cal puv npo thaum lub sijhawm tau txais cov tshuaj CGT (ceeb toom: ob qho tib si Medi-Cal tswj hwm kev saib xyuas thiab tus nqi-rau-kev pabcuam (FFS) cov tswvcuab yuav tsim nyog tau txais kev kho CGT);
Muaj Medi-Cal ua lawv tus thawj them nyiaj;
Tau txais ib qho ntawm ob qho tshuaj CGT los ntawm tus kws kho mob koom nrog; thiab
Ua kom txaus siab rau tag nrho cov CGT Access Model raws li txoj cai tau tshaj tawm Medi-Cal raws li tau teev tseg hauv Medi-Cal Tus Muab Kev Pab Cuam thiab siv tau Txhua Daim Ntawv Npaj.

Nkag mus rau CGT Access Model Services

Kuv yuav ua li cas thiaj tau txais cov tshuaj CGT SCD raws li Medi-Cal tus qauv nkag mus rau GCT?
Yog koj muaj Medi-Cal FFS, koj yuav tsum nrog koj tus kws kho mob tham kom paub seb puas tsim nyog thiab kawm ntxiv thiab kom paub ntxiv txog kev siv cov tshuaj CGT SCD. Cov kws kho mob Medi-Cal FFS tuaj yeem pab cov tswv cuab kom tau txais ib qho ntawm ob hom tshuaj CGT SCD.

Cov tswv cuab ntawm Medi-Cal managed care yuav tsum tiv tauj lawv tus kws kho mob lossis Medi-Cal managed care plan (MCP) kom txiav txim siab seb puas tsim nyog thiab kawm paub ntxiv txog cov kev pabcuam CGT. Cov MCPs ntawm Medi-Cal muaj lub luag haujlwm rau kev sib koom tes saib xyuas thiab pab cov tswv cuab kom tau txais ib qho ntawm ob hom tshuaj kho mob CGT sickle cell. Yog xav paub ntxiv txog kev sib koom tes kho mob Medi-Cal MCP thiab lwm yam uas yuav tsum tau ua, thov saib daim ntawv All Plan Letter uas siv tau ntawm DHCS lub vev xaib. Txhua lub Medi-Cal MCP muaj ib tus neeg uas koj yuav tsum tiv tauj, uas koj tuaj yeem nrhiav tau hauv Phau Ntawv Qhia Txog Kev Npaj Kho Mob Medi-Cal Managed Care.

Yog tias tau txais kev pom zoo rau kev koom nrog hauv Medi-Cal's CGT Access Model kom tau txais LYFGENIA, qhov ntawd yuav tshwm sim qhov twg?
Kev kho mob LYFGENIA tsuas yog muaj thiab tswj hwm ntawm Cov Chaw Kho Mob Tsim Nyog (QTCs) uas muaj kev paub dhau los thiab kev cob qhia tsim nyog los ua li ntawd. Tam sim no muaj yim (8) QTCs uas muab LYFGENIA hauv California, uas tau teev tseg hauv qab no. Koj tuaj yeem tshawb nrhiav cov QTCs ze tshaj plaws rau koj ntawm lub vev xaib no: LYFGENIA ™ (lovotibeglogene autotemcel) Qualified Treatment Center Locator. Koj tus neeg saib xyuas neeg mob LYFGENIA (muaj nrog mybluebirdbio kev sau npe) kuj tseem yuav pab koj txheeb xyuas lub txee QTC rau koj.

Sab Qaum Teb California:
Tsev Kho Mob Menyuam Yaus UCSF Benioff
Oakland 747 52nd Street, Oakland, CA 94608
510-428-3000

Tsev Kho Mob Menyuam Yaus UCSF Benioff San Francisco
1975 4th Street, San Francisco, CA 94158
415-476-2188

Tsev Kho Mob Menyuam Yaus Lucile Packard ntawm Stanford
725 Welch Road, Palo Alto, CA 94304
650-725-3158

Southern California:
UCLA
757 Westwood Plaza, Los Angeles, CA 90095
310-260-6909
310-825-6708

Tsev Kho Mob Menyuam Yaus Los Angeles
4650 Sunset Blvd., Los Angeles, CA 90027
323-361-4624

Lub Tsev Kho Mob Hauv Nroog City of Hope
1500 E Duarte Road, Duarte CA, 91010
1-800-826-4673

Tsev Kho Mob Menyuam Yaus Loma Linda University
11234 Anderson Street, Loma Linda, CA 92354
909-558-4000

Chaw Kho Mob Loma Linda University
11234 Anderson Street, Loma Linda, CA 92354
909-558-4000

Yog tias tau txais kev pom zoo rau kev koom nrog Medi-Cal's CGT Access Model kom tau txais CASGEVY, qhov ntawd yuav tshwm sim qhov twg?
Kev kho mob CASGEVY tsuas yog muaj thiab muab rau ntawm Cov Chaw Kho Mob Tau Tso Cai (ATCs) uas muaj kev paub dhau los thiab kev cob qhia tsim nyog los ua li ntawd. Muaj 6 lub ATC uas muab CASGEVY hauv California. Koj tuaj yeem tshawb nrhiav cov ATCs ze tshaj plaws rau koj ntawm lub vev xaib no: Authorized Treatment Center Locator | CASGEVY ® (exagamglogene autotemcel).

Sab Qaum Teb California:
UCSF Benioff Tsev Kho Mob Menyuam Yaus San Francisco
1975 4th Street
San Francisco, 94158

Tsev Kho Mob Menyuam Yaus Benioff Oakland
747 52nd St.
Oakland, 94609
(510) 428-3885 ext. 13

California Qab Teb:
Lub Nroog Hope National Medical Center
1500 East Duarte Road
Duarte, 91010
(800) 826-4673
genetherapy@coh.org

Tsev Kho Mob Menyuam Yaus ntawm Orange County
1201 W. La Veta Avenue
Orange, 92868

UCLA Health
757 Westwood Plaza
Los Angeles, 90095
310-260-6909

Tsev Kho Mob Menyuam Yaus Los Angeles
4650 Sunset Boulevard
Los Angeles, 90027
(323) 361-4624

Covered CGT Access Model Services, suav nrog Fertility Preservation Services

Kuv yuav tau txais cov txiaj ntsig thiab kev pabcuam dab tsi raws li Medi-Cal tus qauv CGT Access?

Raws li CGT Access Model, cov nqi hauv qab no raug them:
- Ib qho ntawm ob cov tshuaj CGT rau SCD
  - CASGEVY los ntawm Vertex Pharmaceuticals, Inc. - siv tau txij li lub Kaum Hli 1, 2025.
  - LYFGENIA los ntawm bluebird bio, Inc. – siv tau txij lub Xya Hli 1, 2025.
Fertility Preservation Services
- Raws li ib feem ntawm kev them nyiaj rov qab rau CGT SCD cov tshuaj, cov tuam txhab npog:
  - Txog li peb ntu ntawm kev sau thiab khaws cia cov khoom tsim tawm (qe qe, sau cov phev, thiab / lossis cov nqaij mos extraction, thiab lwm yam). Cov txheej txheem tseeb thiab hom kev khaws cia fertility yuav raug txiav txim thiab pom zoo los ntawm Fertility Specialist kws kho mob thiab cov tswv cuab.
  - Kev them nyiaj ua ntej txog li kaum tsib xyoos ntawm kev khaws cov qauv
  - Ib qho kev sib tham thib ob hauv cov xwm txheej uas Tus Kws Kho Mob Fertility txiav txim siab tias tus tswv cuab tsis tsim nyog rau cov kev pabcuam khaws cia muaj menyuam
  - Kev tsim nyog qhov chaw nyob, zaub mov, thiab cov nqi mus ncig kuj yuav raug them, yog tias tsim nyog tau txais cov kev pabcuam fertility preservation

Dab tsi ntawm cov kev pabcuam fertility preservation tsis suav nrog hauv Tus Qauv?
Qee qhov piv txwv ntawm cov kev pabcuam uas TSIS suav nrog yog cov hauv qab no:

Embryo (fertilized qe) creation
Embryo (fertilized qe) cia
In-vitro fertilization (tshwm sim sab nraum lub cev nrog kev pab cuam)

Kuv tuaj yeem txuas nrog cov peev txheej li cas?
Cov tswv cuab Medi-Cal uas tab tom xav txog lossis nyob rau hauv cov txheej txheem ntawm kev tau txais kev kho mob LYFGENIA gene therapy los ntawm bluebird bio yuav tau txais Patient Navigators los ntawm kuv qhov kev txhawb nqa bluebird, uas tuaj yeem:

Txuas cov tswv cuab nrog QTC, uas yog lub tsev kho mob tshwj xeeb uas tau kawm los tswj kev kho mob bluebird biogenes.
Muab cov ntaub ntawv qhia txog ntau yam, suav nrog kev kho noob, kev xeeb tub, kab mob ntawm tes, thiab cov ntaub ntawv tshwj xeeb ntawm cov khoom.
Pab cov tswv cuab nkag siab txog lawv qhov kev pov hwm kev pov hwm thiab cov nqi tawm hauv hnab tshos thiab tej zaum yuav muaj peev xwm txuas tau lawv nrog cov kev pab nyiaj txiag.
Txhawb cov tswv cuab los ntawm txoj kev kho mob thiab txuas lawv mus rau cov peev txheej.
Txiav txim siab tsim nyog rau thiab koom tes nrog cov kev pab cuam kho mob ntxiv, xws li kev pab mus ncig thiab chaw nyob

Thov nco ntsoov tias kuv qhov kev txhawb nqa bluebird muaj rau cov tswv cuab yam tsis tau them nqi, thiab tsis muaj lub luag haujlwm los txav mus rau pem hauv ntej nrog kev kho mob CGT SCD. Yog xav txuas nrog Tus Neeg Saib Xyuas Neeg Mob, thov ua kom tiav daim ntawv sau npe rau kuv qhov kev pabcuam bluebird.

Cov tswv cuab Medi-Cal uas tab tom pib kho mob nrog Vertex Pharmaceuticals' CASGEVY tuaj yeem sau npe rau hauv Vertex Connects kom tau txais Tus Thawj Saib Xyuas Cov Ntaub Ntawv, uas tuaj yeem:

Siv sijhawm los paub koj kom lawv tuaj yeem muab kev txhawb nqa muaj txiaj ntsig
Teb cov lus nug txog kev kho mob thiab qhia cov lus qhia muaj txiaj ntsig los pab cov tswv cuab thiab lawv tsev neeg npaj rau txhua kauj ruam ntawm kev kho mob
Coordinate lub logistics ntawm koj txoj kev kho mob
Txiav txim siab tsim nyog rau thiab koom tes nrog cov kev pab cuam kho mob ntxiv, xws li kev pab mus ncig thiab chaw nyob

Tsis tas yuav sau npe rau hauv Vertex Connects Patient Support kom tau txais CASGEVY. Txawm li cas los xij, yuav tsum muaj daim ntawv sau npe Vertex Connects uas ua tiav lawm kom tau txais cov kev pabcuam tswj xyuas cov ntaub ntawv thiab txiav txim siab seb puas tsim nyog rau qee qhov kev pabcuam. Cov tswv cuab yuav tau txais daim ntawv sau npe Vertex Connects thaum lawv tau txais kev kho mob CASGEVY los ntawm lawv pab neeg kho mob.

Yog tias yuav tsum tau mus ncig kom tau txais kev pab tiv thaiv kev xeeb tub, tus neeg tsim khoom kho mob CGT yuav them cov nqi dab tsi rau tus tswv cuab Medi-Cal?
Cov chaw tsim khoom kho mob CGT muaj lub luag haujlwm them rov qab rau cov tswv cuab tsim nyog rau qhov mais, cov nqi them, thiab chaw nres tsheb thaum nthuav qhia daim ntawv txais nyiaj raug cai, raws li txhua txoj cai ntawm cov chaw tsim khoom. Cov chaw tsim khoom kuj tseem tuaj yeem npaj kev thauj mus los (los ntawm kev caij dav hlau, tsheb ciav hlau, tsheb npav, xauj tsheb) rau tus tswv cuab thiab cov neeg saib xyuas mus thiab los ntawm tus neeg muab kev pab tiv thaiv kev xeeb tub. Yog tias xav tau pw ib hmos, cov chaw tsim khoom kho mob CGT yuav muab ib chav tsev so me me rau ob hmos ib zaug mus ntsib thiab them tus nqi noj mov rau tus tswv cuab thiab lawv niam txiv/tus saib xyuas.

Yog xav paub ntxiv txog kev tsim nyog rau kev them nqi mus ncig thiab kev them rov qab nrog rau kev pab nrog kev npaj mus ncig, cov tswv cuab uas tau txais bluebird bio's LYFGENIA, yuav tsum ua haujlwm nrog lawv Tus Neeg Saib Xyuas Neeg Mob uas tau muab rau thiab siv kuv qhov kev txhawb nqa bluebird. Ib yam li ntawd, cov tswv cuab uas tau txais Vertex's CASGEVY yuav tsum ua haujlwm ncaj qha nrog lawv pab neeg txhawb nqa tus neeg mob Vertex Connects .

Cov txiaj ntsig thiab kev pabcuam twg TSIS YOG ib feem ntawm Medi-Cal's CGT Access Model thiab kuv yuav tau txais lawv li cas?
Tsuas yog ob hom tshuaj CGT thiab, yog tias xav tau, cov kev pabcuam tiv thaiv kev xeeb tub, tag nrho lwm cov kev pabcuam kho mob thiab tsis yog kev kho mob tsis suav nrog hauv CGT Access Model thiab yuav muab thiab them nyob ntawm koj txoj cai Medi-Cal, raws li nram no:

Medi-Cal FFS:
- Cov kws kho mob FFS yuav tsum xa thiab xa daim nqi DHCS ncaj qha rau tag nrho lwm yam kev kho mob thiab tsis yog kev kho mob CGT cov kev pabcuam, suav nrog kev thauj mus los (sab nraum tus nqi ntawm cov tshuaj, kev tiv thaiv kev xeeb tub, thiab kev tsim nyog qhov chaw nyob, pluas noj, thiab kev mus ncig uas tsim nyog tau txais kev pabcuam fertility preservation raws li tau sau tseg saum toj no).
Medi-Cal Managed Care:
- Tus tswv cuab ntawm Medi-Cal txoj kev npaj saib xyuas yuav tsum them rau tag nrho lwm yam kev kho mob thiab tsis yog kev kho mob CGT, suav nrog kev thauj mus los (sab nraum tus nqi ntawm cov tshuaj, kev txuag kev xeeb tub, thiab qhov chaw nyob tsim nyog, pluas noj, thiab kev mus ncig uas tsim nyog tau txais kev pabcuam fertility preservation, raws li tau hais saum toj no).

Tawm tswv yim

Kuv yuav kawm paub ntxiv txog Medi-Cal tus qauv CGT Access thiab/lossis muab tswv yim qhov twg?
Cov ntaub ntawv hais txog Medi-Cal's CGT Access Model muaj nyob rau ntawm DHCS lub vev xaib, uas muaj nyob rau ntawm qhov txuas hauv qab no: Cov lus taw qhia, cov lus nug, thiab cov lus pom kuj tseem tuaj yeem xa mus rau DHCS ntawm email ntawm dhcscgt@dhcs.ca.gov.

Cell thiab Gene Therapy (CGT) Access Model-​​

Medi-Cal Cov Lus Nug Nug Txog Tus Tswv Cuab (FAQs)​​

General​​

Kev tsim nyog​​

Nkag mus rau CGT Access Model Services​​

Covered CGT Access Model Services, suav nrog Fertility Preservation Services​​

Tawm tswv yim​​