トップニュース​​ 

タイラー・サドウィズがメディケイド・パスウェイズ・プログラムに選ばれました​​ 

医療戦略センター（CHCS）は今週、DHCS（ニューヨーク州保健医療サービス局）の行動医療プログラムの副局長であるタイラー・サドウィス氏が、全米から選抜された将来有望なメディケイド機関のリーダー20名のうちの1人として、メディケイド・パスウェイズ・プログラムの第3期生に選ばれたと発表した。タイラーは、メディカルやその他の公的プログラムにおいて、質の高い、利用しやすい専門的な精神保健および薬物乱用障害サービスを確保するという、DHCSの意欲的な計画を主導する責任を担っている。彼は、カリフォルニア州保健福祉省の行動保健チームを率いて、1550万人のメディカル加入者および公的プログラムを通じてサービスを受けているカリフォルニア州民に対し、行動保健医療へのアクセス、質、公平性、およびサービス提供を強化するための取り組みの開発と実施を主導している。​​ 

プログラムの最新情報​​ 

2024 Medi-Cal Managed Care Plan(MCP)移行ポリシーガイド​​ 

On September 29, DHCS released a revised version of the 2024 MCP Transition Policy Guide that includes DHCS policy and MCP requirements related to member transitions of Medi-Cal MCPs that take effect on January 1, 2024. The latest version includes a new MCP transition monitoring and oversight policy and transition-related requirements for incentive programs, as well as updates to all other sections. The policy guide will be updated regularly to keep MCPs informed of new and developing guidance.​​ 

アクセスと健康変革（PATH）技術支援（TA）マーケットプレイス – 改訂版TA受給者アクセス方針​​ 

On September 29, DHCS announced the revised policy for accessing free TA resources available through the PATH TA Marketplace. Effective immediately, all approved TA recipients may now access both off-the-shelf TA projects and hands-on TA projects in all seven TA domains, regardless of if they are contracted with a MCP or other eligible entity to provide Enhanced Care Management (ECM) and/or Community Supports. Learn how free TA services offered through the PATH TA Marketplace can strengthen your organization’s ability to build and deliver quality ECM and Community Supports by visiting the PATH TA Marketplace webpage. Please submit any questions regarding the revised access policy to ta-marketplace@ca-path.com.​​ 

PATH TA Marketplace 第3ラウンド ベンダーアプリケーション​​ 

On October 1, DHCS will open the PATH TA Marketplace Round 3 vendor application window. The PATH TA Marketplace is a virtual marketplace for TA services, a one-stop-shop website where entities can access free TA resources from curated and approved vendors to help build their capacity to transform Medi-Cal. Organizations must apply to qualify as a TA Marketplace vendor before the October 31 deadline. Visit the TA Marketplace vendor webpage for more information and to apply. For questions, please email ta-marketplace@ca-path.com.​​ 

Medi-Cal Rxの​​ 

On September 27 and 28, DHCS delivered the first presentations to update stakeholders on DHCS’ plans to advance Medi-Cal Rx. DHCS presented to the Pharmacy Directors meeting and the California Association of Medical Product Suppliers meeting. Also, on September 22, Reinstatement Phase 4, Lift 2 was successfully implemented. Drug cost ceiling and prior authorization for enteral nutrition and specific standard therapeutic classes for members 22 years of age and older have been reinstated. Additionally, as of September 22, the new COVID-19 vaccines appropriately reimburse the cost of the commercial vaccines (in addition to a $40 incentive fee).​​ 

私たちのチームに参加しませんか​​ 

DHCSは、財務、人事、法務、監査、医療政策、情報技術の各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。​​ 

DHCS’ purpose is to provide equitable access to quality health care leading to a healthy California for all. DHCS’ goals and objectives reflect DHCS’ tremendous work to transform the state’s health care system and strengthen organizational excellence.​​ 

今後のステークホルダーミーティングとウェビナー​​ 

消費者中心のステークホルダー・ワークグループ(CFSW)会議​​ 

10月6日午前10時から11時30分まで、DHCSはCFSW（児童福祉サービス従事者）の会議を開催します。CFSWの目的は、関係者がさまざまな消費者向けメッセージ資料を検討し、フィードバックを提供する機会を提供することです。このフォーラムでは、資格要件や登録に関する活動に焦点を当て、メディカル（Medi-Cal）の政策や機能について自由に議論する機会を提供する。CFSWの参加者は、消費者保護団体の擁護者、医療提供者団体の代表者、および医療分野の専門家です。ご質問はDHCSCFSW@dhcs.ca.govまでメールでお送りください。会議資料はすべて、10月4日までにDHCS CFSWのウェブページに掲載されます。​​ 

CalAIM ICF/DDカーブイン・プロミシング・プラクティス・ウェビナー​​ 

On October 6, from 9:30 to 11 a.m., DHCS will virtually host the third in a series of educational webinars (advance registration required) on the California Advancing and Innovating Medi-Cal (CalAIM) intermediate care facility for the developmentally disabled (ICF/DD) carve-in. The goal of these webinars is to provide stakeholders with an understanding of the ICF/DD carve-in policy requirements and how to support members when all Medi-Cal MCPs will be required to cover and coordinate institutional long-term care for members residing in an ICF/DD beginning on January 1, 2024. The webinar will focus on promising practices that MCPs, ICF/DD homes, and Regional Centers can consider as they prepare for the ICF/DD carve-in to take effect. Webinars are open to the public.​​ 

今後のウェビナーに関する詳細は、 CalAIM ICF/DD長期介護カーブイン移行ウェブページでご確認いただけます。ご質問やご意見は、 LTCtransition@dhcs.ca.govまでメールでお送りください。​​ 

カリフォルニア州のメディケア補償範囲の選択肢:ウェビナー​​ 

On October 11 at 1 p.m., DHCS and the California Department of Aging will jointly host a webinar entitled, “Navigating Medicare Coverage Choices in California, Including Medicare Advantage Supplemental Benefits” (advance registration required). Presenters will include Stephanie Fajuri from the Center for Health Care Rights, an expert in Medicare choices for consumers, and Nils Franco from ATI Advisory, a lead analyst for the review of Medicare Advantage Plan supplemental benefits in California.​​  

The webinar will share helpful information for consumers, families, health care providers, and the public policy community. It will include a presentation and question and answer session on Medicare coverage choices for consumers during the Medicare Open Enrollment period from October 15 to December 7, as well as highlight a newly released DHCS chartbook on supplemental benefits in Medicare Advantage Plans in California for contract year 2023. The chartbook is part of a series of chartbooks available on the DHCS Office of Medicare Innovation and Integration webpage. For questions or comments, please email OMII@dhcs.ca.gov.​​ 

ステークホルダー諮問委員会(SAC)および行動健康-SAC(BH-SAC)会議​​ 

On October 19, from 9:30 a.m. to 3:30 p.m., DHCS will host the next SAC and BH-SAC hybrid meeting (advance registration required). It will open as a joint meeting, with topics shared by SAC and BH-SAC. A BH-SAC-only meeting will be held after the joint meeting; there is no SAC-only meeting. Participants may attend in person at The California Endowment, located at 1414 K Street in downtown Sacramento, or virtually. For more information, please visit the SAC and BH-SAC webpages.​​ 

見逃した場合に備えて​​ 

メディケアMedi-Calプラン:利害関係者向けの情報​​ 

9月22日、DHCSはメディケア・メディカルプランのウェブページに、英語、スペイン語、モン語、ベトナム語、繁体字中国語/広東語、ロシア語、クメール語/カンボジア語のメディケア・メディカルプランのファクトシートを掲載しました。​​  

The 2024 Medicare open enrollment period is from October 15 to December 7, with plan coverage taking effect on January 1, 2024. Californians in 12 counties will be eligible to enroll in Medicare-Medi-Cal Plans, a type of Medicare Advantage plan in California only available to dual eligible members. Medicare Medi-Cal Plans provide more comprehensive care, and benefits in both programs are coordinated by one managed care plan. In 2024, Medicare Medi-Cal Plans will be available in the following counties: Fresno, Kings, Los Angeles, Madera, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Mateo, Santa Clara, and Tulare. Please contact DHCS with any questions or comments about Medicare Medi-Cal Plans at info@calduals.org.​​