トップニュース​​  

カリフォルニア州は、鎌状赤血球症治療を拡大するためのアプリケーションを提出します​​  

On March 11, DHCS applied to CMS to participate in the groundbreaking Cell and Gene Therapy (CGT) Access Model. If accepted, DHCS will implement this multi-year initiative to expand Medi-Cal members’ access to innovative and potentially life-changing therapies for sickle cell disease (SCD), a severe genetic blood disorder that disproportionately impacts people of African descent. Gene therapy represents a groundbreaking approach to SCD. However, these therapies come with extraordinary costs, making access difficult for patients and Medicaid programs, including Medi-Cal. The CGT Access Model addresses this challenge by using a negotiated rebate system that ties payments for these treatments to patient outcomes. If the therapy does not meet expected health improvements, drug manufacturers will provide rebates to Medicaid programs, helping ensure financial sustainability while expanding access to care. If California is approved, eligible Medi-Cal members would gain access to gene therapy treatment, fertility preservation services, case management, travel assistance, and behavioral health support. CMS anticipates testing the model over an 11-year performance period. If approved, California will begin participating in this model on July 1, 2025. 
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従来の医療慣行の福利厚生の実施​​  

On March 21, DHCS published Behavioral Health Information Notice (BHIN) 25-007 – Traditional Health Care Practices Benefit Implementation. This policy, the result of years of dedicated effort and advocacy from California Tribal leaders and partners, provides guidance on the implementation of the traditional health care practices benefit in the Drug Med-Cal Organized Delivery System (DMC-ODS). The federal Centers for Medicare & Medicaid Services (CMS) approved DHCS to cover traditional health care practices provided by Indian Health Care Providers (IHCP) for Medi-Cal members in DMC-ODS counties through December 31, 2026, unless extended or amended. Traditional health care practices encompass two new service types: Traditional Healer and Natural Helper services. DMC-ODS counties will cover Traditional Healer and Natural Helper services provided by IHCPs to Medi-Cal members who meet DMC-ODS access criteria. For questions about traditional health care practices or this BHIN, please email traditionalhealing@dhcs.ca.gov.​​  

Additionally, on April 22, DHCS will present an overview of BHIN 25-007 at the Tribes and Indian Health Program Representatives meeting (advance registration required). The presentation is open to the public and will review policy guidance to support IHCPs and DMC-ODS counties in implementing this new benefit. Attendees are encouraged to submit questions in advance to traditionalhealing@dhcs.ca.gov with the subject line “Traditional Health Care Practices Implementation.” 
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プログラムの最新情報​​ 

公開中:クローズドループ紹介実装ガイダンスに関するウェビナー資料​​  

Effective July 1, 2025, Medi-Cal managed care plans will be required to implement Closed-Loop Referral (CLR) requirements for Enhanced Care Management (ECM) and Community Supports. CLR requirements aim to increase the number of Medi-Cal members successfully connected to these benefits and services. By improving information collection processes, managed care plans will be able to better support individual referrals and address system-level gaps in referral practices and service availability that impact members. DHCS released materials from the February 13 webinar (posted under Informational Webinars) to share more details about these requirements. In the webinar, DHCS provided:​​  

• The Department’s goal and motivation for releasing new CLR requirements.​​ 
• CLR 要件により、紹介の追跡、サポート、および監視作業が合理化され、メンバー紹介プロセスがどのように改善されるか。​​  
• CLR 要件がメンバーが Medically Tailored Meals コミュニティ サポートを受けるのにどのように役立つかを示すユース ケース シナリオの例。​​  

PHMSection@dhcs.ca.gov でのCalifornia Advancing and Innovating Medi-Cal(CalAIM)の人口健康管理イニシアチブに関する質問やコメントについては、DHCSにお問い合わせください。
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私たちのチームに参加しませんか​​ 

DHCS は、財務、人事、薬局、行動健康などのチームで人材を募集しています。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​​ 

DHCS は、イベントカレンダーに今後の公開会議を掲載します。
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カバレッジアンバサダーウェビナー​​  

3 月 25 日午前 11 時から午後 12 時 (PDT) まで、DHCS は Coverage Ambassador ウェビナー (事前登録が必要) を開催し、医療オプションと Medi-Cal の最新情報に関する情報を提供します。カバレッジ アンバサダーは、Medi-Cal の特典、登録情報、そしてすべての人にとって健康的なカリフォルニアの実現に重点を置いた新しいプロジェクトについての情報を広めるのに役立ちます。詳細については、 Coverage Ambassador のWeb サイトをご覧ください。または、Coverage Ambassador に登録して、定期的な更新情報を受け取ってください。
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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 March 27, from 10 a.m. to 12 p.m. PDT, DHCS will host the CalAIM MLTSS and Duals Integration Workgroup meeting (advance registration required). The workgroup is a stakeholder collaboration hub for CalAIM MLTSS and integrated care for dual eligible members. It allows stakeholders to provide feedback and share information about policy, operations, and strategy for upcoming changes to Medi-Cal and Medicare. The meeting agenda includes updates on Medicare enrollment data for dual eligible members, the Dual Eligible Special Needs Plan (D-SNP) Dashboard, D-SNP initiatives, and the D-SNP State Medicaid Agency Contract and Policy Guide. It also includes data updates on Enhanced Care Management and Community Supports for dual eligibles and a Community Supports service spotlight presentation on select service definition updates.​​  

More information, background materials, transcripts, and video recordings of previous workgroup meetings are posted on the CalAIM MLTSS and Duals Integration Workgroup webpage. For questions or comments, please email DHCS at info@calduals.org.  
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医療提供者および聴覚専門家向けの子供向け補聴器カバレッジプログラム(HACCP)ウェビナー​​  

On March 27, from 12 to 1 p.m. PDT, DHCS will host the quarterly HACCP webinar for medical providers and hearing professionals. For more information and to register, please visit DHCS’ HACCP webpage. Registration information will be posted as the webinar date approaches. 
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見逃した場合に備えて​​ 

オープン中:アクセスの提供と医療の変革(PATH)容量とインフラストラクチャの移行、拡張、開発(CITED)ラウンド4アプリケーション​​  

On January 6, DHCS opened the PATH CITED Round 4 application window, which includes funding opportunities to support the implementation of the new transitional rent Community Support. The PATH CITED initiative provides funding to build the capacity and infrastructure of on-the-ground partners, including community-based organizations, hospitals, county agencies, Tribes, and others, to successfully participate in Medi-Cal. All organizations providing the transitional rent Community Support must do so in partnership with their county behavioral health department. To demonstrate this partnership, all CITED applicants planning to request funding to support the transitional rent Community Support must also submit a Letter of Support in collaboration with the county behavioral health department.​​   

PATH CITED Round 4の資金調達の申請期限は、2025年5月2日午後11時59分(太平洋夏時間)です。ガイダンス文書とアプリケーションは、PATH CITEDのWebページで入手できます。ご不明な点が ございましたら、cited@ca-path.com までお送りください。
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