Cov Chaw Saib Xyuas Qib Nruab Nrab - Cov Neeg Muaj Kev Tsis Taus Hauv Kev Loj Hlob, Cov Neeg Uas Muaj Kev Xav Tau Kev Pab thiab Cov Neeg Saib Xyuas Neeg Mob
Cov nqi them rov qab rau Cov Chaw Saib Xyuas Qib Nruab Nrab, Cov Neeg Muaj Kev Tsis Taus Hauv Kev Loj Hlob (ICF/DD), Cov Neeg Muaj Peev Xwm Nyob Tau (ICF/DD-H), thiab Cov Neeg Saib Xyuas Neeg Mob (ICF/DD-N) raug hloov kho txhua xyoo siv txoj kev ntsuas tus nqi uas tsis tau khov, sib koom ua ke, thiab raws li tus nqi raws li Daim Ntawv Ntxiv 4.19-D ntawm California Medicaid State Plan. Cov chaw kho mob raug muab faib ua pawg raws li qib kev saib xyuas thiab qhov loj ntawm lub txaj. Cov nqi them rov qab rau txhua pawg neeg sib npaug yog tsim los ntawm 65th feem pua ntawm cov nqi kwv yees ntawm pawg neeg raws li cov ntaub ntawv nqi tshaj tawm tshiab tshaj plaws thiab tau tshuaj xyuas kho rau kev nce nqi, ntxiv rau tus nqi kwv yees ntawm kev ua raws li lub xeev lossis tsoomfwv cov lus txib tshiab (xws li kev nce nyiaj hli tsawg kawg nkaus ntawm lub xeev) thiab Tus Nqi Kev Ntsuam Xyuas Zoo (QAF). Txij li Lub Yim Hli 1, 2022, cov Kev Them Nyiaj Ntxiv ntawm Proposition 56 yav dhau los tau hloov pauv mus rau suav nrog ua ib feem ntawm tus nqi tsis khov, raws li tus nqi.
Vim yog COVID-19 Kev Noj Qab Haus Huv Pej Xeem (PHE) ua rau muaj kev nyuaj siab rau cov nqi kho mob uas cov chaw kho mob tau them vim muaj COVID-19 PHE, DHCS tau muab cov chaw kho mob no nrog kev nce tus nqi ib ntus rau COVID-19 PHE sib npaug li 10 feem pua ntawm lawv cov nqi them txhua hnub xyoo 2019-20 rau lub sijhawm ntawm PHE, raws li tau pom zoo hauv Txoj Kev Npaj Hloov Kho Xeev 20-0024.
Raws li Senate Bill 184 (Tshooj 47, Statutes of 2022), uas tau hloov kho Welfare and Institutions Code § 14105.075, DHCS tab tom tsim kom muaj kev txwv tsis pub siv rau hnub tim ntawm kev pabcuam tom qab qhov kawg ntawm PHE hauv Txoj Cai Hloov Kho Txoj Kev Npaj Hauv Xeev 22-0061 uas tau pom zoo. Cov kev cai txwv tsis pub ua txhaum cai yuav qhia tias tom qab hnub kawg ntawm PHE, cov chaw yuav tau txais ntau dua ntawm:
- Tus nqi tsis khov, tus nqi raws li tau piav qhia saum toj no, lossis
- Tag nrho cov nyiaj them rov qab tau siv rau hnub kawg ntawm PHE, suav nrog COVID-19 PHE tus nqi nce ib ntus.
Kev them rov qab ICF/DD tau hloov ntawm lub Yim Hli mus rau Lub Xya Hli tus nqi txhua xyoo mus rau lub xyoo tus nqi txhua xyoo, siv tau rau Lub Ib Hlis 1, 2024, raws li tau pom zoo hauv Txoj Cai Hloov Kho Txoj Kev Npaj ntawm Lub Xeev 23-0032.
Thov saib tsab ntawv qhia txog Kev Npaj Txhua Yam hauv qab no rau cov kev cai uas siv rau MCPs:
- APL 26-012 Cov Chaw Saib Xyuas Qib Nruab Nrab Rau Cov Neeg Uas Muaj Kev Tsis Taus Hauv Kev Loj Hlob - Kev Pab Saib Xyuas Mus Ntev Hauv Kev Tswj Xyuas Kev Saib Xyuas (Hloov APL 24-011)
Tus Nqi Xyoo 2027
Kev Tshawb Fawb Txog Tus Nqi CY 2027
Daim ntawv hauv qab no muaj cov qauv tshuaj xyuas pej xeem rau ICF-DD (H/N) CY 2027 tus nqi raws li California Medicaid State Plan (Ntxiv 4.19-D)
Cov Kev Tshawb Fawb Txog Kev Ntsuam Xyuas Pej Xeem Xyoo 2027 muaj cov qauv pib ntawm cov nqi ntawm cov chaw hauv xyoo (CY) 2027 thiab tsuas yog muab rau pej xeem saib xyuas xwb. Cov ntawv qauv no tsis hloov kho cov nqi Medi-Cal uas muaj nyob hauv cov ntaub ntawv thiab tsis yog rau kev them nqi lossis lwm yam kev siv. Cov nqi kawg ntawm CY 2027 yuav txawv ntawm cov uas tau teev tseg hauv Kev Tshawb Fawb Txog Kev Ntsuam Xyuas Pej Xeem raws li kev hloov pauv lossis kev kho cov ntaub ntawv hauv qab, kev hloov pauv tsim nyog kom tau txais kev pom zoo los ntawm tsoomfwv, thiab lwm yam kev hloov tshiab uas pom zoo raws li DHCS qhov kev txiav txim siab. Thov saib cov lus tsis lees paub uas muaj nyob rau thaum pib ntawm txhua daim ntawv Tshuaj Xyuas Pej Xeem kom paub meej ntxiv.
DHCS txhawb kom cov chaw ua haujlwm saib xyuas lawv cov kev tshawb fawb txog tus nqi thiab txheeb xyuas qhov tseeb ntawm lawv cov nqi uas tau tshaj tawm, tshwj xeeb tshaj yog cov uas ua lub hauv paus rau kev tsim tus nqi (piv txwv li, cov nqi peev, cov nqi ua haujlwm, cov nqi tsis yog kev ua haujlwm, thiab lwm yam).
DHCS thov kom muaj lus tawm tswv yim lossis tswv yim tsis pub dhau lub Kaum Hli Ntuj hnub tim 16, 2026. Yog koj muaj lus nug lossis lus tawm tswv yim, thov xa email rau LTCReimbursement@dhcs.ca.gov nrog rau kab ntawv "CY 2027 Rates Public Review Draft."
CY 2026 Tus nqi
CY 2026 Rate Study
Cov ntaub ntawv hauv qab no muaj cov qauv zaum kawg rau ICF-DD (H/N) CY 2026 tus nqi raws li California Medicaid State Plan (Ntawm 4.19-D).
CY 2026 Tus Nqi Txoj Cai Tsab Ntawv
Tus Nqi Xyoo 2026 ntawm ICF/DD - Siv Tau Txij Lub Ib Hlis 1, 2026 txog Lub Kaum Ob Hlis 31, 2026 (Luam tawm thaum 10/31/2025)
| Hom chaw | Tus nqi Code | Tus nqi Tus lej Tus nqi | Cov lej nyiaj tau los | Total Reimbursement Per Diem | Tus nqi Code | Tus nqi Tus lej Tus nqi | Cov lej nyiaj tau los | Total Bed Hold Reimbursement Per Diem |
|---|---|---|---|---|---|---|---|---|
| ICF/DD 1-59 txaj | 24 | 41 | 0101 | $ 433.48 | 24 | 43 | 0180 | $ 423.53 |
| ICF/DD 60+ txaj | 24 | 42 | 0101 | $ 421.42 | 24 | 44 | 0180 | $ 411.47 |
| ICF/DD-H 4-6 txaj | 24 | 61 | 0101 | $ 424.66 | 24 | 63 | 0180 | $ 414.71 |
| ICF/DD-H 7-15 txaj | 24 | 65 | 0101 | $ 430.91 | 24 | 68 | 0180 | $ 420.96 |
| ICF/DD-N 4-6 txaj | 24 | 62 | 0101 | $ 451.20 | 24 | 64 | 0180 | $ 441.25 |
| ICF/DD-N 7-15 txaj | 24 | 66 | 0101 | $ 485.42 | 24 | 69 | 0180 | $ 475.47 |
Nco tseg:
- Daim ntawv teev nqi tau hloov kho tshiab raws li Daim Ntawv Thov LTC thiab Kev Hloov Kho Code.
- 2026 Daim Ntawv Qhia Xyoo Lub txaj tuav tus nqi yog $ 9.95.
- Managed Care cov koom haum yuav xa mus rau Total Reimbursement and the Total Bed Hold Reimbursement.
Tus Nqi Xyoo 2025 ntawm ICF/DD - Siv tau rau lub Ib Hlis 1, 2025 txog rau lub Kaum Ob Hlis 31, 2025
Luam tawm 12/30/2024
| Hom chaw | Tus nqi Code | Tus nqi Tus lej Tus nqi | Cov lej nyiaj tau los | Total Reimbursement Per Diem | Tus nqi Code | Tus nqi Tus lej Tus nqi | Cov lej nyiaj tau los | Total Bed Hold Reimbursement Per Diem |
|---|---|---|---|---|---|---|---|---|
| ICF/DD 1-59 txaj | 24 | 41 | 0101 | $ 383.31 | 24 | 43 | 0180 | $ 373.54 |
| ICF/DD 60+ txaj | 24 | 42 | 0101 | $ 421.42 | 24 | 44 | 0180 | $ 411.65 |
| ICF/DD-H 4-6 txaj | 24 | 61 | 0101 | $ 403.44 | 24 | 63 | 0180 | $ 393.67 |
| ICF/DD-H 7-15 txaj | 24 | 65 | 0101 | $ 392.18 | 24 | 68 | 0180 | $ 382.41 |
| ICF/DD-N 4-6 txaj | 24 | 62 | 0101 | $ 424.05 | 24 | 64 | 0180 | $ 414.28 |
| ICF/DD-N 7-15 txaj | 24 | 66 | 0101 | $ 477.62 | 24 | 69 | 0180 | $ 467.85 |
Nco tseg:
- Daim ntawv teev nqi tau hloov kho tshiab raws li Daim Ntawv Thov LTC thiab Kev Hloov Kho Code.
- Xyoo 2025 Calendar Lub txaj tuav tus nqi yog $ 9.77.
- Managed Care cov koom haum yuav xa mus rau Total Reimbursement and the Total Bed Hold Reimbursement.
Tus Nqi Xyoo 2024 ntawm ICF/DD - Siv tau txij lub Ob Hlis 1, 2024 txog rau lub Kaum Ob Hlis 31, 2024
| Hom chaw | Tus nqi Code | Tus nqi Tus lej Tus nqi | Cov lej nyiaj tau los | Total Reimbursement Per Diem | Tus nqi Code | Tus nqi Tus lej Tus nqi | Cov lej nyiaj tau los | Total Bed Hold Reimbursement Per Diem |
|---|---|---|---|---|---|---|---|---|
| ICF/DD 1-59 txaj | 24 | 41 | 0101 | $ 369.73 | 24 | 43 | 0180 | $ 360.21 |
| ICF/DD 60+ txaj | 24 | 42 | 0101 | $ 421.42 | 24 | 44 | 0180 | $ 411.90 |
| ICF/DD-H 4-6 txaj | 24 | 61 | 0101 | $ 363.12 | 24 | 63 | 0180 | $ 353.60 |
| ICF/DD-H 7-15 txaj | 24 | 65 | 0101 | $ 378.14 | 24 | 68 | 0180 | $ 368.62 |
| ICF/DD-N 4-6 txaj | 24 | 62 | 0101 | $ 394.48 | 24 | 64 | 0180 | $ 384.96 |
| ICF/DD-N 7-15 txaj | 24 | 66 | 0101 | $ 445.65 | 24 | 69 | 0180 | $ 436.13 |
Nco tseg:
- Daim ntawv teev nqi tau hloov kho tshiab raws li Daim Ntawv Thov LTC thiab Kev Hloov Kho Code.
- Xyoo 2024 Calendar Lub txaj tuav tus nqi yog $ 9.52.
- Managed Care cov koom haum yuav xa mus rau Total Reimbursement and the Total Bed Hold Reimbursement.
Tus Nqi Xyoo 2024 ntawm ICF/DD - Siv Tau Lub Ib Hlis Ntuj hnub tim 1, 2024 txog Lub Ib Hlis Ntuj hnub tim 31, 2024
| Hom chaw | Cov lej cim qhia txog kev pabcuam txwm muaj | Total Reimbursement Per Diem | Kev Tuav Txaj Kev Pab Tus lej | Total Bed Hold Reimbursement Per Diem |
|---|---|---|---|---|
| ICF/DD 1-59 txaj | 41 | $ 369.73 | 43 | $ 360.21 |
| ICF/DD 60+ txaj | 41 | $ 421.42 | 43 | $ 411.90 |
| ICF/DD-H 4-6 txaj | 61 | $ 363.12 | 63 | $ 353.60 |
| ICF/DD-H 7-15 txaj | 65 | $ 378.14 | 68 | $ 368.62 |
| ICF/DD-N 4-6 txaj | 62 | $ 394.48 | 64 | $ 384.96 |
| ICF/DD-N 7-15 txaj | 66 | $ 445.65 | 69 | $ 436.13 |
Nco tseg:
- Xyoo 2024 Calendar Lub txaj tuav tus nqi yog $ 9.52.
- Managed Care cov koom haum yuav xa mus rau Total Reimbursement and the Total Bed Hold Reimbursement.
Tiv tauj peb
Thov xa cov lus nug txog cov nqi ICF/DD mus rau LTCReimbursement@dhcs.ca.gov.