医療費負担適正化法
Under the Affordable Care Act (ACA), states were authorized to expand Medicaid, effective January 1, 2014, to many low-income individuals under age 65 who were previously ineligible for coverage. The ACA established a new income eligibility limit of 138 percent of the federal poverty level, increasing the number of Californians eligible. As of March 2016, more than 4.7 million Californians have begun receiving comprehensive health care benefits provided by Medi-Cal since the ACA was implemented.
The Department of Health Care Services’ (DHCS) vision is to preserve and improve the physical and mental health of all Californians, and the department’s mission is to provide Californians with access to affordable, high-quality health care, including medical, dental, mental health, substance use treatment services, and long-term care. The ACA’s expansion of Medi-Cal allows California to make significant strides toward supporting a healthier, more productive state. Medi-Cal also assists the most vulnerable among us, whose circumstances may prevent them from accessing health coverage or vital health care services. Below are various programs and services members are benefitting from as a result of the ACA.
個人
The Hospital Presumptive Eligibility (PE) program, effective January 1, 2014, provides individuals with temporary, no-cost Medi-Cal benefits for up to two months.
Medi-Cal Eligibility and Covered California
DHCS has partnered with Covered California to create an online “one-stop shop” for health coverage.
Medi-Cal Eligibility and Covered California FAQs
DHCS has developed frequently asked questions for current and potential Medi-Cal coverage recipients to help them access the care they need.
ステークホルダー
1991年の州保健再編のリダイレクトには、ACAが含まれます。
California Mental Health Planning Councilは、連邦法および州法により、深刻な感情障害を持つ子供、および深刻な精神疾患を持つ成人および高齢者を擁護することを義務付けられています。 評議会は、公的精神保健システムの監督と説明責任を提供し、優先問題について行政と議会に助言し、州全体の計画に参加します。
Medi-Cal’s Implementation of New Programs
Medi-Calは、ACAの制定の一環として新しいプログラムを実施しました。
プロバイダー
プロバイダーの報告に関するMedi-Calガイダンス-予防可能な状態
2012年7月1日より、すべてのプロバイダーは、Medi-Cal患者の治療中に発生するプロバイダーの予防可能な状態を報告する必要があります。
メディケア&メディケイドサービスセンターは、2011年2月2日に連邦官報(42 CFR Parts 405, 424, 447 et al.)に最終規則を公表し、メディケア、メディケイド、および子供の健康保険プログラムに関連して、プロバイダーのスクリーニングとプロバイダーの詐欺や虐待の防止のために実施する規定を盛り込んだ。この規則は、ACAの規定を実施しました。