Tsev Cov Kev Pabcuam Cov Kev Pabcuam Medi-Cal Kev Tso Cai Rau Superior Systems​​ 

Superior Systems Waiver​​ 

Tsoom Fwv Teb Chaws Chaw rau Medicare & Medicaid Cov Kev Pabcuam tau pom zoo rau Superior Systems Waiver (SSW) daim ntawv thov rov ua dua tshiab, siv tau rau tsib xyoos, Lub Kaum Hli 1, 2024 txog lub Cuaj Hli 30, 2029. Daim ntawv tso cai zam thiab cov ntaub ntawv cuam tshuam muaj nyob hauv qab no hauv Cov Txheej Txheem Zoo Tshaj Plaws Tam Sim No Rov Ua Dua Tshiab Lub Kaum Hli 1, 2024 - Cuaj Hlis 30, 2029 ntu.​​ 

The SSW describes the utilization review (UR) process for acute inpatient hospitals that serve fee-for-service Medi-Cal patients.  Under SSW authority, the Department of Health Care Services (DHCS) employs the following UR approaches, depending on the type of acute inpatient service, the hospital type, and the characteristics of the beneficiary’s health care coverage.​​  

  • Kev Thov Kev Tso Cai Kho Mob (TAR) txheej txheem: TAR txheej txheem xav kom DHCS tso cai rau cov neeg mob hauv tsev kho mob ua ntej pom zoo them nyiaj rov qab. Cov tsev kho mob xa TARs rau DHCS rau kev tshuaj xyuas thiab kev pom zoo ntawm kev tso npe nkag los xyuas kom meej tias kev kho mob tau ua tiav ua ntej thov kev pabcuam.​​  
  • T​​ Cov txheej txheem AR-Free: Cov txheej txheem TAR-Free yuav tsum tau cov tsev kho mob siv cov qauv tshuaj xyuas kev kho mob raws li pov thawj, los txiav txim siab qhov tsim nyog kho mob thiab thov rau cov kev pabcuam hauv tsev kho mob, thaum DHCS ua cov kev tshuaj xyuas kev ua raws li kev kho mob thiab kev tswj hwm tom qab them nyiaj siv cov qauv piv txwv ntawm cov ntawv thov them nyiaj hauv tsev kho mob uas raug cai.​​  

Thov xa koj cov lus nug txog SSW mus rau qhov chaw nyob email Clinical Assurance Division (CAD) hauv qab no: SSWRenewal@dhcs.ca.gov.​​ 

Current Superior Systems Waiver Renewal October 1, 2024 – September 30, 2029​​                           

Txuas rau Ua Ntej Superior Systems Waivers​​