DHCS Stakeholder Update – March 17, 2023
인기 뉴스
지속적인 보장 범위 축소 기간 동안 자산 유연성에 대한 새로운 DHCS 연방 요청
On March 10, DHCS submitted a waiver flexibility request to the Centers for Medicare & Medicaid Services (CMS) to support the unwinding of the continuous coverage requirement. The Section 1902(e)(14)(A) waiver flexibility seeks to make it easier for Non-Modified Adjusted Gross Income (MAGI), for example seniors and persons with disabilities, to renew their Medi-Cal coverage—and remain covered until California eliminates the asset limit on January 1, 2024. It will allow counties to use existing case file information to grant eligibility during renewals, and disregard any increases in assets since the last Medi-Cal determination. Also, for individuals who were not initially subject to an asset test at the time of their Medi-Cal application, but have now transitioned into a program requiring one, the waiver flexibility would allow California to renew based on their last known eligibility determination on file. DHCS is requesting this authority to be effective retroactive to March 1, 2023, and remain in effect through December 31, 2023.
The requested waiver flexibility only applies to Medi-Cal renewals and not to new applications. New Medi-Cal applications, specifically for Non-MAGI programs, are still subject to the asset test until it is eliminated. The asset test for new Medi-Cal non-MAGI applications was raised to $130,000 per individual and $65,000 per additional person on July 1, 2022. It is important to note that non-MAGI Medi-Cal members will still need to meet all other Medi-Cal eligibility criteria, including income, to remain Medi-Cal eligible at redetermination.
CMS가 승인하면 DHCS는 Medi-Cal 자격 부서 정보 서한을 통해 카운티에 즉시 지침을 발행합니다.
프로그램 업데이트
2024년 메디-메디 플랜을 추가 카운티로 확대 적용
Starting January 1, 2024, DHCS will expand the availability of Medi-Medi Plans for dual eligible Medicare and Medi-Cal members to five additional central valley counties: Fresno, Kings, Madera, Sacramento, and Tulare. Medi-Medi Plans for dual eligible Medicare and Medi-Cal members are currently available in the seven former Coordinated Care Initiative (CCI) counties: Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Mateo, and Santa Clara.
Medi-Medi Plans is the California-specific program name for Medicare Advantage Exclusively Aligned Enrollment Dual Eligible Special Needs Plans (D-SNPs). Under Medi-Medi Plans, dual eligible members can voluntarily enroll in a D-SNP for Medicare benefits and in a Medi-Cal managed care plan (MCP) for Medi-Cal benefits, which are both operated by the same parent organization for better care coordination and integration.
DHCS는 메디 메디 플랜에 대한 자세한 정보를 제공하기 위해 5개 확장 카운티의 지역 이해 관계자와 만나고 있으며, 향후 관리형 장기 서비스 & 지원 & 이중 통합 작업 그룹 회의에 이 주제를 포함할 예정입니다. 메디 메디 플랜에 대한 자세한 내용은 메디케어 메디칼 플랜 웹페이지에서 확인할 수 있습니다. 궁금한 점이 있으면 OMII@dhcs.ca.gov 으로 문의해 주세요.
건강 등록 네비게이터 프로젝트
내비게이터 프로젝트는 최근 옹호자 및 이해관계자 커뮤니케이션, 프로젝트 파트너, 일반 공지사항/기타 커뮤니케이션을 위해 보다 타겟화된 정보를 제공하기 위해 웹페이지를 업데이트했습니다. 프로젝트 파트너 웹페이지에는 상원 법안(SB) 154 자금 지원과 관련된 구체적인 정보, 카운티별 지역 커뮤니티 기반 조직 및 하청 단체 목록, 등록 및 유지 목표, 자금 지원 금액, 하청 업체 및 서비스 대상 인구 등 높은 수준의 업무 노력을 자세히 설명하는 프로젝트 파트너 요약도 포함되어 있습니다.
클리닉을 위한 천연두 백신 투여에 대한 연방 승인
CMS recently approved a State Plan Amendment (SPA) to reimburse vaccine-only encounters at the fee-for-service (FFS) rate at certain clinics, retroactive to August 17, 2022. SPA 22-0062 pertains to Federally Qualified Health Centers (FQHC), Rural Health Clinics (RHCs), Indian Health Services Memorandum of Agreement (IHS-MOA), and Tribal FQHC clinic providers.
Effective March 10, 2023, FQHC, RHC, IHS-MOA, and Tribal FQHCs may submit claims for members enrolled in Medi-Cal managed care for Mpox vaccine-only encounters. Likewise, claims for FFS members may be submitted by FQHC, RHC, IHS-MOA, and Tribal FQHC providers using the instructions published in the December 13, 2022, article “Mpox Vaccines Reimbursement at the Medicare Rate“.
This reimbursement policy is effective for dates of service on or after August 17, 2022, through January 31, 2023, the end of the Mpox state public health emergency (PHE). At the conclusion of the PHE, the reimbursement rates for Mpox vaccine administration returned to the Medi-Cal FFS rates in effect at that time. Providers are reminded that each administration of the Mpox vaccine falls under a qualifying office visit or vaccine-only encounter, not both.
FQHC, RHC, IHS-MOA, and Tribal FQHC providers will receive a 120-day timeliness override to submit the Mpox vaccine-only encounters.
인도 전통 보건(TIH) 신청 요청(RFA) 공개
During the week of March 20, DHCS anticipates the release of a RFA to fund three TIH education programs that will assist Indian clinics in providing services to American Indians in a culturally appropriate manner and to provide a forum for the Indian community to address TIH education. A total of $300,000 is available to fund regional TIH programs for two fiscal years. This funding opportunity supports the provision of traditional Indian health care. Funds for this project are part of the $11,576,000 allocated in the fiscal year 2022-23 budget for the restoration of Indian Health Program grant programs.
It is anticipated that $100,000 per region will be made available to support each regional program for two fiscal years. The maximum funding is $50,000 per region per fiscal year. The grant term is projected to start in May 2023 and continue through June 30, 2024.
For questions about the RFA, please email TribalAffairs@dhcs.ca.gov.
팀에 합류하세요
DHCS는 재정, 인사, 법무, 감사, 건강 정책, 정보 기술 팀에서 채용을 진행 중입니다. 자세한 내용은 CalCareers 웹사이트를 참조하세요.
DHCS is dedicated to preserving and improving the overall health and well-being of all Californians. DHCS’ mission is to provide the most vulnerable residents with equitable access to affordable, integrated, and high-quality health care, and is currently transforming the Medi-Cal program to make sure it provides the care Californians need to live healthier, happier lives.
예정된 이해관계자 회의 및 웨비나
California’s Reproductive Health Access Section 1115 Demonstration: Tribal and Designee of Indian Health Programs Webinar
On March 20, from 9 to 10 a.m., DHCS will host a Medi-Cal Tribal and Designee of Indian Health Programs webinar (advance registration required) to provide information and receive feedback on California’s Reproductive Health Access Demonstration (CalRHAD) 1115 request in advance of DHCS’ submission to CMS. Tribal partners have been invited to participate in the webinar via email.
California’s Reproductive Health Access Section 1115 Demonstration: First Public Hearing
On March 29, from 10 to 11 a.m., DHCS will host the first (advance registration required) of two public hearings to solicit stakeholder comments on a proposed CalRHAD Medicaid Section 1115 demonstration. DHCS is seeking approval from CMS to provide competitive grants to reproductive health providers to enhance capacity and access to sexual and reproductive health services, promote the sustainability of California’s reproductive health provider safety net, and benefit individuals enrolled in Medi-Cal and other individuals who currently face barriers to such access.
치료 도구의 선별 및 전환 정보 웨비나
On March 29, from 3 to 4 p.m., DHCS will hold a Screening and Transition of Care Tools webinar (advance registration required) to discuss the Adult and Youth Screening and Transition of Care Tools for Medi-Cal Mental Health Services, which went live on January 1, 2023, as part of California Advancing and Innovating Medi-Cal (CalAIM). This initiative is focused on implementing statewide screening and transition of care tools for both adults and individuals under 21 years old for use by Medi-Cal MCPs and county mental health plans. The webinar will include an overview of the purpose of the initiative, a discussion on notable requirements and case examples, and responses to frequently asked questions. For more information, please visit the Screening and Transition of Care Tools webpage.
아동 및 청소년 행동 건강 이니셔티브(CYBHI) 월간 공개 웨비나: 2023년 3월
On March 29, from 3 to 4 p.m., DHCS will virtually host a webinar (advance registration required) to keep stakeholders apprised of DHCS’ progress in implementing various workstreams for CYBHI. Key attendees include, but are not limited to, youth, parents, family members, behavioral health providers, Medi-Cal MCPs, county behavioral health departments, and commercial health plans, as well as educational and other cross-sector partners.
Doula 이해관계자 워킹그룹 회의
3월 30일 오후 12시부터 2시까지 DHCS는 둘라 서비스에 관한 첫 번째 공개 가상 이해관계자 워크그룹 회의를 개최합니다. SB 65는 DHCS가 Medi-Cal에서 둘라 혜택의 시행을 검토하기 위해 실무 그룹을 소집하도록 규정하고 있습니다. 이 실무 그룹은 Medi-Cal 가입자가 둘라 서비스를 이용할 수 있도록 보장하는 방법을 논의하고, 둘라에 대한 지불 장벽과 지연을 최소화하는 방법을 고려하며, 가입자가 이용 가능한 둘라 서비스를 알 수 있도록 홍보 활동을 권장할 것입니다. 미팅 등록 링크는 3월 24일까지 doula 웹페이지에서 확인할 수 있습니다.
CYBHI RFA 기술 지원 웨비나
On March 30, from 1 to 2 p.m., DHCS will virtually host a public CYBHI webinar (advance registration required) on behalf of the Evidence-Based Practices (EBP) and Community-Defined Evidence Practices (CDEP) grants program. This webinar will focus on the “Round Two: Trauma-Informed Programs and Practices” RFA. DHCS will provide technical assistance by sharing responses to frequently asked questions received based on themes. During the webinars, DHCS will not address any live questions. Please email questions related to the Round Two RFA to CYBHI@dhcs.ca.gov. DHCS will post the FAQs to the CYBHI EBP/CDEP grants webpage by March 17.
놓친 경우를 대비하여
캘리포니아, 오피오이드 위기 해결을 위해 2160만 달러 지원
On March 13, DHCS awarded $12 million to 44 programs through the California Youth Opioid Response project, and $9.6 million to 28 entities through the Low-Barrier Opioid Treatment at Syringe Services Programs project. This is the latest investment in a running total of more than half a billion dollars to help prevent opioid overuse and addiction, address opioid use disorders safely and effectively, and reduce overdose deaths.
DHCS, 아동 및 청소년을 위한 행동 건강 가상 서비스 플랫폼에 대한 업데이트 제공
On March 15, DHCS confirmed it will launch the Behavioral Health Virtual Services Platform, a new technology-enabled services solution for all children, youth, and families in California, in January 2024. The platform is part of Governor Newsom’s Master Plan for Kids’ Mental Health and CYBHI. For more information, please visit the CYBHI webpage.
캘리포니아의 생식 건강 접근성 섹션 1115 데모
On March 16, DHCS launched 30-day public and Tribal public comment periods to solicit feedback on a proposed CalRHAD Medicaid Section 1115 demonstration. DHCS is seeking approval from CMS to provide competitive grants to reproductive health providers to enhance capacity and access to sexual and reproductive health services, promote the sustainability of California’s reproductive health provider safety net, and benefit individuals enrolled in Medi-Cal and other individuals who currently face barriers to such access.
Additional information about the CalRHAD application is available on the CalRHAD webpage.