홈 뉴스 캘리포니아, 남부 캘리포니아 산불로 피해를 입은 메디칼 가입자를 위한 지원 확대 노력​​ 

캘리포니아, 남부 캘리포니아 산불로 피해를 입은 메디칼 가입자를 위한 지원 확대 노력​​ 

1월 17, 2025​​ 

SACRAMENTO — In response to the devastating Southern California wildfires and Governor Gavin Newsom’s proclaimed State of Emergency and Executive Order issued on January 7, 2025, the Department of Health Care Services (DHCS) swiftly implemented key administrative flexibilities to protect Medi-Cal members in affected regions of the state. These efforts include simplified Medi-Cal enrollment and renewal processes, waived requirements to access prescription medications and medical devices, and other flexibilities to ensure all Medi-Cal members have access to care during this emergency.​​ 

Help for Medi-Cal members in Los Angeles County and Ventura County includes:​​ 

  • Simple renewal and enrollment: Simplified Medi-Cal enrollment and renewal processes to allow families to quickly secure or maintain Medi-Cal coverage. Allowed for self-attestation for residency and income if documentation is missing, and verification deadlines are extended. Local county offices are prioritizing Medi-Cal applications and any case restorations for affected Medi-Cal members, who are encouraged to contact their local clinic navigators or local county office if assistance is needed to resolve eligibility issues.​​ 
  • Fast refills for pharmacy and medical equipment: Waived prescription signature requirements for Medi-Cal members. Released a provider alert to allow for early refill authorizations and emergency override of existing utilization management and prior authorization controls to facilitate expedited access to medications and pharmacy products to ensure timely care.​​ 
  • Prioritized member transfers if moving out of Los Angeles or Ventura counties: Medi-Cal members who are displaced for an unknown amount of time may contact either their former county of residence or the new county to assist with transferring the case on a permanent or short-term basis. Members can visit the DHCS website to find their local county office.​​ 
  • Emergency response protocols: Medi-Cal managed care plans that operate in the areas subject to the emergency, including L.A. Care Health Plan, Health Net, Molina Healthcare, Gold Coast Health Plan, Kaiser Permanente, Anthem, Blue Shield of California Promise Health Plan, Senior Care Action Network, and Positive Healthcare California (AIDS Healthcare Foundation), have activated their emergency response protocols. Protocols include deploying care management teams to conduct member outreach, especially for high needs populations; waiving prior authorization requirements; working to provide transportation to care; and ensuring members do not face any out-of-pocket costs for getting care from out-of-network providers, as needed.​​ 

DHCS understands recovering from these wildfires will be challenging and has developed an online resource to help answer Medi-Cal member questions about accessing services during this emergency.​​ 

Current flexibilities for Medi-Cal managed care plans and providers include:​​ 

  • Behavioral health services: Ensured relocated clients from evacuated facilities receive continuous care, with licensing and certification flexibilities supporting affected treatment programs.​​ 
  • Provider support: Extended reporting and administrative deadlines, enabling Medi-Cal providers to prioritize care delivery until the end of the emergency.​​ 
  • Managed care flexibility: Waived prior authorizations and referral requirements for applicable services to help Medi-Cal managed care plans and their network providers deliver timely care to members affected by evacuations and service disruptions.​​ 

Additionally, DHCS submitted requests to the federal Centers for Medicare & Medicaid Services (CMS) to help Californians covered by Medi-Cal impacted by the Southern California wildfires. Section 1135 of the Social Security Act provides flexibility during national public health emergencies.​​ 

“At DHCS, our members are our top priority, and our hearts go out to the families affected by the Southern California wildfires,” said DHCS Director Michelle Baass. “We are working closely with CMS to obtain speedy federal approvals for flexibilities to help our state and Medi-Cal members meet the challenges posed by the wildfires. We will continue to issue guidance to providers so they can quickly take advantage of the new flexibilities to deliver quality, equitable health care to Southern Californian Medi-Cal members.”​​ 

Significant additional flexibilities requested by DHCS include:​​ 

  • 진료소 및 시설 지원​​ 
    • 주요 시설이 손상되었거나 접근할 수 없는 경우 이동 진료소 또는 임시 장소와 같은 대체 환경에서 진료를 제공할 수 있도록 허용합니다.​​ 
    • 대피소 및 호텔 등 임시 보호 시설에서 제공되는 서비스에 대한 전액 환급을 승인합니다.​​ 
  • Medi-Cal 회원을 위한 추가 보호 기능:​​ 
    • 공정한 청문회 요청 및 혜택 복원에 대한 일정을 연장하여 Medi-Cal 가입자에게 자격 또는 혜택 문제를 해결할 수 있는 추가 시간을 제공합니다.​​ 
    • 현재 제약 조건으로 인해 대면 만남이 지연될 수 있도록 재택 의료 서비스 요건을 조정하세요.​​  
  • 메디칼 제공자 등록 및 환급:​​ 
    • 의료 제공자 등록을 신속하고 간소화하여 의료 제공자가 영향을 받은 가입자에게 더 쉽게 의료 서비스를 제공할 수 있도록 합니다.​​ 
  • 장기 서비스 및 지원(LTSS)을 위한 유연성:​​ 
    • 초기 평가, 재평가 및 치료 계획 검토 일정을 연장하여 연령, 장애 또는 만성 질환으로 인해 지속적인 지원이 필요한 개인이 중단 없이 치료를 받을 수 있도록 합니다.​​ 
    • 대피소나 호텔과 같은 대체 장소에서 LTSS를 배송할 수 있도록 허용합니다.​​ 
  • 보고 및 청구 요건 연장:​​ 
    • 데이터 보고 및 청구서 제출 기한을 연장하여 영향을 받은 지역 기관 및 교육 기관이 기한을 준수할 수 있도록 지원합니다.​​ 
    • 산불로 인해 정상적인 운영이 중단되는 경우에도 의료 플랜이 회원에게 서비스를 계속 제공할 수 있도록 보고 요건을 보다 유연하게 충족할 수 있도록 합니다. 조정에는 회원들이 치료를 위해 얼마나 멀리 이동해야 하는지, 얼마나 빨리 LTSS를 이용할 수 있는지에 대한 규칙 조정이 포함됩니다.​​ 

DHCS is dedicated to safeguarding the health and well-being of Medi-Cal members and communities suffering from the devastating effects of the Southern California wildfires. DHCS’ purpose extends beyond routine health care services, focusing on proactive planning, rapid response, and continuous support in the face of challenges like these wildfires.​​ 

주, 지방, 연방 및 부족 파트너와의 협력을 통해 DHCS는 영향을 받은 개인이 필수 의료 서비스를 적시에 이용할 수 있도록 보장합니다. DHCS는 팀의 전문성과 응급 규정의 유연성을 활용하여 의료 및 행동 건강 서비스에 대한 접근을 촉진하는 것부터 의약품 및 내구성 있는 의료 장비의 가용성 보장에 이르기까지 남부 캘리포니아 지역사회의 고유한 요구 사항을 해결합니다.​​ 

BACKGROUND: On January 8, 2025, in response to the catastrophic wildfires in Southern California, President Joseph R. Biden, Jr. declared that a major disaster exists in the State of California in the areas affected by wildfires. On January 10, 2025, U.S. Department of Health & Human Services Secretary Xavier Becerra declared a public health emergency for California, granting CMS additional flexibility to address the health needs of impacted individuals. These measures were made possible through extensive preparedness planning and proactive emergency response protocols. These efforts underscore a strong state and federal partnership, ensuring uninterrupted care and services during this emergency.​​ 

DHCS administers Medi-Cal, California’s version of Medicaid, providing health coverage to nearly 15 million people, including nearly 4 million members in Los Angeles County and more than 250,000 members in Ventura County.​​ 

DHCS encourages all affected residents to follow local evacuation orders, monitor air quality, and wear masks outdoors, if needed. If Medi-Cal members need assistance, they should contact their health care provider or plan.​​  

추가 정보: 다음 링크에서 리소스 및 업데이트를 확인할 수 있습니다:​​ 

지금 바로 도움을 받으세요:​​ 

  • Californians can visit CA.gov/LAfires, a hub for information and resources from state, local, and federal governments.​​ 
  • 산불로 인해 손실을 입은 개인 및 사업주는 재난 지원을 신청할 수 있습니다:​​ 
  • DisasterAssistance.gov에서 온라인으로 확인하세요.​​ 
  • 800-621-3362로 전화하세요.​​ 
  • 연방재난관리청(FEMA) 스마트폰 애플리케이션을 사용합니다.​​ 
  • 40개 이상의 언어로 지원이 제공됩니다.​​ 
  • 비디오 중계 서비스, 자막 전화 서비스 등과 같은 중계 서비스를 사용하는 경우, 해당 서비스 번호를 FEMA에 알려주십시오.​​ 

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연락처:​​ 
Office of Communications
(916) 440-7660
www.dhcs.ca.gov​​