April 29. 2024 – Stakeholder Update
トップニュース
DHCSは、行動健康治療センターのリボンカットを祝います
On April 25 and 26, DHCS celebrated the addition of two new facilities that will provide lifesaving treatment for Californians with mental health and substance use disorders (SUD). Paving the Way Foundation in Los Angeles County and Center Point Drug Abuse Alternatives Center in Sonoma County are expanding behavioral health treatment and recovery options in their local communities. These are among the first of many community treatment sites supported by the Behavioral Health Continuum Infrastructure Program and are under construction now in 49 counties. Even more sites will be funded and built, thanks to recently approved Proposition 1 bonds.
プログラムの最新情報
Medi-Cal Rxクレームの新しいコード1診断要件
Effective April 30, Code 1 Diagnosis Requirement – Reject Code 80 claim utilization management (UM) edits will be implemented for members 22 years of age and older. Medi-Cal Rx will use diagnosis code(s) from the member’s Medi-Cal medical record to meet the Code 1 diagnosis restriction. Code 1 drugs are subject to prescription documentation requirements, and prescribers and pharmacy providers must document the treatment diagnosis and keep that information readily available for auditing purposes. Code 1 diagnosis requirements can be met in one of four ways: provide a diagnosis with the prescription, communicate the diagnosis verbally to the pharmacy provider, submit a prior authorization request with the diagnosis, or use an acceptable diagnosis code that is on file in the Medi-Cal data system. Members 21 years of age and younger are not impacted.
スマイル、カリフォルニア州モバイルデンタルバンツアーは続きます
On May 4, the Smile, California mobile dental van tour will stop in Huntington Park. During the event, individuals will have access to various dental services, such as exams, X-rays, cleaning, and fluoride applications. More information about Medi-Cal-covered dental services is available on the Smile, California website.
私たちのチームに参加しませんか
DHCSは、コミュニケーション、人事、監査、医療政策、情報技術、およびその他のチームを募集しています。 詳細については、 CalCareersのWebサイトをご覧ください。
今後のステークホルダーミーティングとウェビナー
Medi-Cal Children’s Health Advisory Panel (MCHAP)
On May 1, from 10 a.m. to 2 p.m., DHCS will hold the MCHAP hybrid meeting (advance registration required). MCHAP advises DHCS on policy and operational issues that affect children in Medi-Cal. The panel consists of a 15-member advisory body whose members include recognized stakeholders and experts in their fields, medical professionals, advocates, and parent members. If you are interested in receiving information about MCHAP meetings or have general inquiries, please email MCHAP@dhcs.ca.gov.
消費者中心のステークホルダー・ワークグループ(CFSW)
On May 3, from 10 to 11:30 a.m., DHCS will convene the CFSW, which provides stakeholders an opportunity to review and provide feedback on a variety of consumer messaging materials. The forum focuses on eligibility- and enrollment-related activities and strives to offer an open discussion on Medi-Cal policies and functionality. Meeting materials, including the meeting agenda, will be posted to the CFSW webpage no later than May 1. Please email your questions to DHCSCFSW@dhcs.ca.gov.
Medi-Cal Dental Los Angeles ステークホルダーミーティング
5月14日午後1時から3時まで、DHCSはMedi-Cal Dental Los Angelesのステークホルダーミーティングを開催します。 DHCSは、新しい活動や今後の活動に関する最新情報や情報を共有します。 この会議はまた、歯科の利害関係者に、口腔医療サービスの提供を改善するのに役立つMedi-Cal Dentalチームと意見を共有するためのフォーラムを提供します。 会議情報は、 DHCS Medi-Cal Dental Los Angeles Stakeholder MeetingsのWebページに掲載されます。 追加の資料は、会議の前または利用可能になり次第、Webページに掲載されます。 ご質問は dental@dhcs.ca.gov までメールでお問い合わせください。
ステークホルダー諮問委員会(SAC)/行動健康(BH)-SAC会議
On May 29, from 9:30 a.m. to 3 p.m., DHCS will convene the SAC/BH-SAC hybrid meeting (advance registration required). The meeting will include an update on Proposition 1 implementation. SAC provides DHCS with valuable input on ongoing California Advancing and Innovating Medi-Cal (CalAIM) implementation efforts, as well as helps DHCS further its efforts to provide high-quality, equitable care.
BH-SAC is a broad-based body that disseminates information and receives coordinated input regarding DHCS behavioral health activities. It was created as part of the ongoing DHCS effort to integrate behavioral health with the rest of the health care system and incorporates existing groups that have advised DHCS on behavioral health topics.
CalAIMマネージド長期サービスおよびサポート(MLTSS)およびDuals統合ワークグループ会議
On May 30 at 10 a.m., DHCS will host the CalAIM MLTSS and Duals Integration Workgroup virtual meeting (advance registration is required). The workgroup serves as a stakeholder collaboration hub for CalAIM MLTSS and integrated care for dual eligible members and allows stakeholders to provide feedback and share information about policy, operations, and strategy for upcoming changes to Medi-Cal and Medicare.
アジェンダのトピックには、デュアル適格特別ニーズプラン(D-SNP)州メディケイドエージェンシー契約(SMAC)とポリシーガイド、デュアル適格メンバーのメディケア登録データ、デフォルト登録パイロット、2025年メディケア&メディケイドサービスセンター(CMS)メディケアアドバンテージとパートD最終規則に関する最新情報、およびデュアル適格メンバー向けの強化されたケア管理とコミュニティサポートに関するプレゼンテーションが含まれます。
以前のワークグループ会議の背景資料、トランスクリプト、ビデオ録画、およびワークグループに関する追加情報は、 CalAIM MLTSS and Duals Integration WorkgroupのWebページに掲載されています。 ご質問やご意見は、 info@calduals.org までメールでお問い合わせください。