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 FAQs hauv qab no muab kev qhia ntxiv thiab kev qhia meej rau cov tswv cuab Medi-Cal txog CGT Access Model. Raws li Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS) tau txais cov lus nug ntxiv, FAQ no yuav raug hloov kho. Yog xav paub ntxiv txog CGT Access Model, thov xa mus rau General FAQs.
General
Kuv txoj kev kho 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
Kuv yuav paub li cas cov tshuaj CGT SCD kuv yuav tau txais los ntawm Medi-Cal's CGT Access Model?
Medi-Cal's CGT Access Model yuav them rau ob lub tseemfwv qibsiab Food and Drug Administration (FDA)-pom zoo CGT tshuaj rau kev kho mob mob hlwb (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 yog qhov tsim nyog tshaj plaws rau koj tus kheej cov xwm txheej thiab xa daim ntawv thov tsim nyog rau koj tus kheej kom koj tuaj yeem koom nrog CGT Access Model thiab tau txais cov tshuaj CGT SCD.
Cov tshuaj CGT rau SCD puas tuaj yeem cuam tshuam rau kuv lub cev xeeb tub (muaj peev xwm muaj menyuam)?
Yog lawm, chemotherapy siv los hloov cov qia cell thaum kho CGT tej zaum yuav cuam tshuam koj fertility (muaj peev xwm muaj menyuam). Txawm li cas los xij, vim qhov tseeb no, cov kev pabcuam khaws cia muaj menyuam tau raug them thiab muaj rau cov tswvcuab raws li Medi-Cal's CGT Access Model. Koj raug txhawb kom tham txog cov kev xaiv khaws cia fertility nrog koj tus kws kho mob ib zaug pom zoo rau tab sis ua ntej pib kho CGT. Thov saib Covered CGT Access Model Services, Nrog rau Fertility Preservation Services seem ntawm 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 nkag mus rau CGT SCD cov tshuaj li cas hauv Medi-Cal's GCT Access Model?
Yog tias koj muaj Medi-Cal FFS, koj yuav tsum sab laj nrog koj tus kws kho mob kom txiav txim siab txog kev tsim nyog thiab kawm ntxiv nrog rau cov ntaub ntawv ntawm kev nkag mus rau CGT SCD cov tshuaj. Medi-Cal FFS cov chaw muab kev pabcuam tuaj yeem pab cov tswvcuab nkag mus rau ib qho ntawm ob qho tshuaj CGT SCD.
Medi-Cal tswj xyuas cov tswv cuab yuav tsum hu rau lawv tus kws kho mob lossis Medi-Cal tswj hwm txoj kev npaj kho mob (MCP) txhawm rau txiav txim siab tsim nyog thiab kawm paub ntxiv txog cov kev pabcuam CGT. Medi-Cal MCPs yog lub luag haujlwm rau kev saib xyuas kev sib koom tes thiab pab cov tswvcuab nkag mus rau ib qho ntawm ob qho tshuaj CGT mob cell. Yog xav paub ntxiv txog Medi-Cal MCP kev saib xyuas kev sib koom tes thiab lwm yam uas yuav tsum tau ua, thov tshuaj xyuas Daim Ntawv Qhia Tag Nrho uas siv tau ntawm DHCS lub vev xaib. Txhua Medi-Cal MCP suav nrog cov ntsiab lus ntawm kev sib cuag, uas tuaj yeem pom hauv Medi-Cal Managed Care Health Plan Directory.
Yog tias pom zoo rau kev koom tes hauv Medi-Cal's CGT Access Model kom tau txais LYFGENIA, qhov ntawd yuav tshwm sim?
LYFGENIA cov kev kho mob tsuas yog muaj thiab tswj hwm ntawm Qualified Treatment Centers (QTCs) cov chaw uas muaj kev tsim nyog thiab kev cob qhia ua li ntawd. Tam sim no muaj yim (8) QTCs uas muab LYFGENIA hauv California, uas yog cov mos txwv hauv qab no. Koj tuaj yeem tshawb nrhiav QTCs ze tshaj plaws rau koj ntawm lub vev xaib no: LYFGENIA ™ (lovotibeglogene autotemcel) Tsim Nyog Kev Kho Mob Locator. Koj lub LYFGENIA tus neeg mob navigator (muaj nrog mybluebirdbio cuv npe) kuj tuaj yeem pab koj txheeb xyuas QTC txee rau koj.
Northern California:
UCSF Benioff Children's Hospital
Oakland 747 52nd Street, Oakland, CA 94608
510-428-3000
UCSF Benioff Children's Hospital San Francisco
9 th CA, San Francisco 79
415-476-2188
Lucile Packard Children's Hospital 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
Children's Hospital Los Angeles
4650 Sunset Bl, Los Angeles, CA 4650.
323-361-4624
Lub Nroog Hope National Medical Center
1500 E Duarte Road, Duarte CA, 91010
1-800-826-4673
Loma Linda University Children's Hospital
11234 Anderson Street, Loma Linda, CA 92354
909-558-4000
Loma Linda University Medical Center
11234 Anderson Street, CA 4 Loma Linda
909-558-4000
Yog tias pom zoo rau kev koom tes hauv Medi-Cal's CGT Access Model kom tau txais CASGEVY, qhov twg yuav tshwm sim?
Kev kho mob CASGEVY tsuas yog muaj thiab tswj hwm ntawm Cov Chaw Kho Mob Tso Cai (ATCs) uas muaj kev paub tsim nyog thiab kev cob qhia ua li ntawd. Muaj 6 ATCs uas muab CASGEVY hauv California. Koj tuaj yeem tshawb nrhiav ATCs ze tshaj plaws rau koj ntawm lub vev xaib no: Tso Cai Kho Mob Locator | CASGEVY ® (exagamglogene autotemcel).
Northern California:
UCSF Benioff Children's Hospital San Francisco
1975 4th Street
San Francisco, 94158
Benioff Children's Hospital Oakland
197nd St. 9 Oakland,
(510) 428-3885 ext. 5183
13
Southern California:
Lub Nroog Hope National Medical Center
1500 East Duarte Road
Duarte, 91010
(800) 826-4673
genetherapy@coh.org
Children's Hospital of Orange County
1201 W. La Veta Avenue
Orange, 92868
UCLA Health
757 Westwood Plaza
Los
, 90095
609-09-09-2009
Children's Hospital Los Angeles
4650 Sunset Boulevard
Los Angeles, 90027
(323) 361-4624
Covered CGT Access Model Services, suav nrog Fertility Preservation Services
Kuv tuaj yeem tau txais cov txiaj ntsig thiab kev pabcuam dab tsi hauv Medi-Cal's CGT Access Model?
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?
Medi-Cal cov tswv cuab uas tab tom txiav txim siab lossis tab tom tau txais bluebird bio's LYFGENIA gene therapy kho yuav tau txais Patient Navigators los ntawm kuv qhov kev txhawb nqa bluebird, leej twg 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 muaj nqi, thiab tsis muaj lub luag haujlwm los mus tom ntej nrog CGT SCD kev kho mob. Txhawm rau txuas nrog Tus Neeg Mob Navigator, thov ua kom tiav kuv qhov kev txhawb nqa bluebird's Program Enrollment Form.
Medi-Cal cov tswv cuab uas tab tom pib kho nrog Vertex Pharmaceuticals 'CASGEVY tuaj yeem tso npe rau hauv Vertex Connects kom tau txais Tus Thawj Saib Xyuas Case, leej twg 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
Kev cuv npe hauv Vertex Connects Patient Support tsis tas yuav tau txais CASGEVY. Txawm li cas los xij, yuav tsum tau ua tiav daim ntawv teev npe Vertex Connects kom tau txais cov kev pabcuam tswj xyuas thiab txiav txim siab tsim nyog rau qee qhov kev pabcuam. Cov tswv cuab yuav tau txais daim ntawv teev npe Vertex Connects thaum lawv tau txais kev kho mob CASGEVY los ntawm lawv pab neeg kho mob.
Cov nuj nqis dab tsi raug them rau Medi-Cal tus tswv cuab los ntawm CGT cov chaw tsim khoom kho mob yog tias tsim nyog mus ncig kom tau txais cov kev pabcuam tiv thaiv kev xeeb tub?
CGT cov tuam txhab kho mob yog lub luag haujlwm los muab cov nyiaj them rov qab rau cov tswv cuab tsim nyog rau kev caij tsheb kauj vab, tus lej xov tooj, thiab chaw nres tsheb thaum nthuav tawm cov ntawv txais tau siv tau, ua raws li tag nrho cov chaw tsim khoom siv txoj cai. Cov neeg tsim khoom kuj tseem tuaj yeem npaj kev thauj mus los (ntawm huab cua, tsheb ciav hlau, tsheb npav, tsheb xauj) rau cov tswv cuab thiab cov neeg zov me nyuam mus rau thiab los ntawm tus kws kho mob tshwj xeeb. Yog tias yuav tsum tau nyob ib hmos, CGT cov tuam txhab kho mob tuaj yeem muab chav tsev so me me txog li ob hmo rau ib qho kev mus ntsib thiab tsim nyog ib qho khoom noj khoom haus rau cov tswv cuab thiab lawv niam lawv txiv / tus neeg zov me nyuam.
Yog xav paub ntxiv txog kev tsim nyog tau txais kev pab them nqi mus ncig thiab them nyiaj rov qab nrog rau kev pab cuam nrog kev npaj mus txawv tebchaws, cov tswvcuab tau txais bluebird bio's LYFGENIA, yuav tsum ua haujlwm nrog lawv tus neeg saib xyuas tus neeg mob thiab siv kuv qhov kev txhawb nqa bluebird. Ib yam li ntawd, cov tswv cuab tau txais Vertex's CASGEVY yuav tsum ua haujlwm ncaj qha nrog lawv pawg neeg pab txhawb nqa neeg mob Vertex Connects .
Cov txiaj ntsig thiab kev pabcuam dab tsi tsis yog ib feem ntawm Medi-Cal's CGT Access Model thiab kuv yuav tau txais lawv li cas?
Ib sab ntawm ob cov tshuaj CGT thiab, yog tias xav tau, cov kev pabcuam khaws cia kom muaj menyuam, tag nrho lwm yam kev pabcuam khomob thiab tsis yog kev khomob tsis raug them raws li CGT Access Model thiab yuav muab thiab them raws li koj qhov kev tsim nyog Medi-Cal, raws li hauv qab 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 tuaj yeem kawm paub ntau ntxiv txog Medi-Cal's CGT Access Model thiab/los yog muab cov lus qhia txog 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 teb, cov lus nug, thiab cov lus pom tuaj yeem xa tuaj rau DHCS ntawm email ntawm dhcscgt@dhcs.ca.gov.
