DHCS Stakeholder News – August 12, 2022
이해관계자 여러분,
보건의료서비스부(DHCS)에서 DHCS 프로그램과 관련된 중요한 개발 사항을 업데이트합니다.
인기 뉴스
DHCS, 연방 파트너에게 몬키폭스 지침 요청
On August 12, DHCS sent a letter to the Centers for Medicare & Medicaid Services (CMS) requesting immediate guidance for establishing a Medicare rate for the monkeypox vaccine administration.
In an effort to be responsive to our Medi-Cal beneficiaries and providers, California will submit a Disaster State Plan Amendment to seek federal approval to reimburse vaccine administration and applicable laboratory testing at 100 percent of the Medicare rate, once established. As part of this request, DHCS will seek federal approval to reimburse Federally Qualified Health Centers, and similarly situated clinics that are paid an all-inclusive rate, the vaccine administration fee for vaccine-only visits, consistent with how DHCS is reimbursing for COVID-19 vaccine-only visits. The requested federal approvals will also include reimbursement for vaccine administration performed by non-clinic providers.
Additionally, please see the Centers for Disease Control and Prevention’s Reducing Stigma in Monkeypox Communication and Community Engagement and the California Department of Public Health’s toolkit messaging for sharing broadly among your networks.
메디칼 보험료 환불
상원 법안 184(옴니버스 건강 법안 2022)는 DHCS가 Medi-Cal 프로그램의 보험료를 0으로 낮출 수 있도록 승인했습니다. 7월 1, 2022일부터 다음 프로그램에 가입한 회원은 더 이상 자격 요건으로서 보험료를 납부할 필요가 없습니다:
- Optional Targeted Low Income Children’s Program
- Medi-Cal 액세스 프로그램
- 메디칼 액세스 영유아 프로그램
- County Children’s Health Initiative Program
- 250% 근로 장애인 프로그램
DHCS released policy guidance via All County Welfare Directors Letter #22-14 and Medi-Cal Eligibility Division Information Letter #I 22-25, and is seeking federal authority to implement this policy through SPA 22-0042 and SPA 22-0034, which are pending CMS approval. Furthermore, DHCS has begun the process of issuing refunds to Medi-Cal and Children’s Health Insurance Program (CHIP) beneficiaries who overpaid their premiums as of July 1.
U.S. Surgeon General’s Comments on the Children and Youth Behavioral Health Initiative (CYBHI)
In a recent SAGE Journals article, U.S. Surgeon General Dr. Vivek H. Murthy highlighted the work that is underway through the CYBHI. The article serves as a call to action for the nation, with a stark reminder of what’s at stake in ensuring that children and youth receive the help they need when and where they need it, especially those in our most underserved communities.
The CYBHI, which includes multiple work streams that are led by five departments and offices within the California Health & Human Services Agency (CalHHS) – DHCS, Department of Health Care Access and Information, Department of Managed Health Care, California Department of Public Health, and the Office of the California Surgeon General – focuses on promoting mental, emotional, and behavioral well-being by preventing challenges and providing services, support, and routine screening for all children and youth for emerging and existing needs.
프로그램 업데이트
고령 캘리포니아 주민을 위한 메디칼 아웃리치 및 등록 지원
DHCS는 잠재적으로 Medi-Cal 건강 보험 혜택을 받을 수 있는 28,000명의 노인에게 홍보 및 등록 지원을 제공하고 있습니다. DHCS는 캘리포니아 주 카운티 협회 및 캘리포니아 보장성 & 건강 이니셔티브(CCHI)에 30, 2024 6월까지 등록 지원 노력에 협력하기 위해 2,400만 달러를 지원했습니다. 노력의 대상은 다음과 같습니다:
- 이중 자격 수혜자 또는 65세 이상의 수혜자로 Medi-Cal 자격 재결정이 보류 중인 경우.
- 65세 이상으로서 이미 메디칼에 가입되어 있고 메디케어 자격 여부를 판단하는 데 도움이 필요한 사람.
- 65세 이상 또는 장애가 있는 개인으로서 Medi-Cal 수혜 자격이 있지만 현재 가입하지 않은 경우(메디케어 저축 프로그램 수혜 자격이 있는 경우 포함).
- 이민 신분에 관계없이 50세 이상 성인으로 Medi-Cal이 확대됨에 따라 새로 Medi-Cal 수혜 자격이 생긴 개인.
- 65세가 되는 메디칼 수혜자 중 아직 메디케어에 가입하지 않은 경우, 해당 카운티의 하나 이상의 메디칼 매니지 케어 플랜(MCP)과의 계약에 따라 달라질 수 있습니다.
CCHI는 Medi-Cal 수혜자를 대상으로 수년간 아웃리치 및 등록 지원을 수행한 경험이 있는 지역사회 기반 단체의 지원을 받아 Medi-Cal 수혜 자격이 있는 사람들이 의료 서비스에 대한 접근성을 높여 결과를 개선하고 건강 격차를 줄일 수 있도록 할 것입니다. 자세한 내용은 캘리포니아주 고령자를 위한 Medi-Cal 지원 및 등록 웹페이지를 참조하세요.
CHIP 등록 및 재결정 정책 업데이트
On August 3, CMS approved DHCS’ State Plan Amendment (SPA) CA-22-0035 submission, allowing DHCS to implement provisions for temporary adjustments to enrollment and redetermination policies. Effective July 1, 2022, DHCS is able to use a regulatory timeliness exception for the timely processing of CHIP applications and renewals for children in families living and/or working in state- or federally-declared disaster areas.
캘리포니아는 이번 SPA를 통해 SPA CA-17-0043을 통해 승인된 재해 구호 조항을 2022년 3월에 발표된 업데이트된 재해 구호 SPA 템플릿과 일치시키기 위해 기술적으로 변경하고 있습니다. 이러한 SPA 조항은 향후 주 또는 연방에서 선포한 재난이 발생했을 때 해당 조항의 발효일과 재난의 영향을 받는 지역을 CMS에 통지하여 시행할 수 있습니다.
모바일 위기 서비스 정보 요청(RFI) 공개
On August 8, DHCS released a RFI for the mobile crisis services benefit. The RFI invites vendors to provide DHCS with information to support training for and implementation of mobile crisis services. DHCS intends to submit a SPA to add qualifying community-based mobile crisis intervention services as a new Medi-Cal benefit, effective no sooner than January 2023. Implementing mobile crisis services is an integral part of California’s broader efforts to strengthen the continuum of community-based care for Medi-Cal beneficiaries who are experiencing a mental health or substance use disorder crisis.
DHCS는 교육, 준비 상태 검토 및 기술 지원과 관련된 자료 및 지침을 포함하는 Medi-Cal 모바일 위기 서비스 혜택을 개발 중입니다.
병원 및 전문 요양 시설 COVID-19 근로자 고용유지 지원금 프로그램
DHCS는 이 프로그램의 기록 날짜 및 최종 제출일과 관련하여 업데이트된 지침을 제공하고 있습니다:
- 기록 날짜 기준으로 유자격 직원은 28년 2022월 일까지 적격 시설의 보장 대상 법인 또는 보장 서비스 고용주에게 고용되어 있어야 유지 보수 지급을 받을 수 있습니다.
- 최종 제출일인 30년 2022월 일 오후 5시까지 대상 법인 및 대상 서비스 고용주는 적격 직원 목록을 포함한 신청서를 제출해야 합니다.
향후 몇 주 내에 DHCS는 주간 이해관계자 공지사항과 병원 및 전문 요양 시설 COVID-19 근로자 고용 유지 지원금 웹페이지를 통해 제출 절차 및 일반 업데이트에 대한 추가 지침을 제공할 예정입니다.
어린이 보청기 보장 프로그램(HACCP) 업데이트
DHCS는 7월 1, 2021일 이후 서비스 날짜에 소급 적용하여 골전도 보청기(BCHD)와 관련된 새로운 HACCP 혜택을 포함하도록 보조 코드 A1에 대한 보장 혜택을 확대했습니다.
For more information about HACCP coverage of BCHDs, please see the Medi-Cal Provider Newsflash. For information about the program more broadly, please see DHCS’ HACCP webpage, which was recently expanded to include additional resources for families and providers, including a secure chat option for communicating with the HACCP Call Center or uploading additional materials for an application that has already been submitted. Additionally, families seeking to apply for HACCP coverage may now submit their application electronically through the HACCP Online Application Portal.
Medi-Cal Rx 구현 업데이트
DHCS와 마젤란(MMA)은 청구 편집 및 사전 승인(PA) 요건의 단계적 복원을 위한 집중적인 계획 프로세스에 참여했습니다.
- 1단계인 22, 2022월 일에 시행되어 약물 간 상호작용, 고용량, 조기 리필 등과 같은 DUR 경고에 대한 전국 처방약 프로그램 위원회(NCPDP) 거부 코드 88 - 약물 활용 검토(DUR) 거부 오류에 대한 청구 편집을 복원했습니다. 복귀 접근 방식은 점진적이고 반복적이며 이해관계자의 준비와 성과 모니터링에 중점을 두고 있습니다. 데이터 분석, 운영 경험, 이해관계자 피드백을 바탕으로 시간이 지남에 따라 필요에 따라 개선될 것입니다.
- 현재 시행 중인 1단계 2단계는 CoverMyMeds(CMM) 사용을 촉진하는 데 중점을 둡니다.
- Phase one, wave three is slated to begin on September 16 with the reinstatement of PA requirements for 11 drug classes for new start prescriptions for beneficiaries 22 years of age and older. Stakeholders are encouraged to continue submitting comments and feedback on the reinstatement approach via Reinstatement@dhcs.ca.gov.
지역사회 보건 종사자(CHW) 스파 승인
On July 26, DHCS received CMS approval for SPA 22-0001, which adds CHW as a preventive service. Developed in consultation with stakeholders, this SPA created CHW services as a Medi-Cal benefit, effective July 1, 2022, for both fee-for-service and managed care delivery systems. For more information about CHW services, including a link to the provider manual, please see the CHW webpage.
게시된 코로나19 정보
예정된 이해관계자 회의 및 웨비나
캘리포니아 발전 및 혁신 메디캘(CalAIM) 웨이버 갱신 웨비나
On August 22 at 10 a.m., DHCS will virtually host a public hearing to receive stakeholder feedback on the proposed amendments to the CalAIM Section 1115 demonstration and Section 1915(b) waiver. Please register for this webinar in advance.
DHCS launched 30-day public comment and Tribal public comment periods on August 12. DHCS is seeking the CalAIM Section 1115 and 1915(b) amendment approvals from CMS to implement county-based model changes in the Medi-Cal Managed Care (MCMC) program. Through the Section 1915(b) waiver amendment, DHCS also plans to add or update language on policies or programs in the approved CalAIM 1915(b) waiver, including to reflect the MCMC model changes in select counties and direct contracts with the Kaiser Foundation Health Plan available for enrollment of certain Medi-Cal beneficiary populations in select counties. Additional information about the CalAIM Section 1115 demonstration application and Section 1915(b) overview are available on the CalAIM 1115 Demonstration & 1915(b) Waiver webpage. The 30-day public comment and Tribal public comment periods end on September 12.
가족 PACT 고객과 HPV 예방접종에 대해 이야기하기
On August 17, DHCS and the California Prevention Training Center will hold a webinar to provide information about the effectiveness and safety of the human papillomavirus (HPV) vaccine, review current Centers for Disease Control and Prevention recommendations for the use of the HPV vaccine, and provide advice on how to have effective shared decision-making conversations with clients about being immunized. Advance registration for PACT webinar is required. Effective July 1, 2022, the Family PACT program added HPV vaccination as a clinic benefit for individuals ages 19 through 45. For those unable to attend the live webinar, a transcript and recording of the webinar, along with additional resources, will be available on the Family PACT website.
메디칼 치과 주 전체 이해관계자 회의
8월 18일 오전 10시에 DHCS는 가상 Medi-Cal 치과 주 전체 이해관계자 회의를 개최합니다. 이 회의의 목적은 주 전역의 치과 이해 관계자들에게 Medi-Cal 치과 프로그램에 대한 피드백을 공유할 수 있는 포럼을 제공하고 DHCS가 신규 또는 예정된 업무 노력에 대한 중요한 업데이트 및 정보를 공유하는 것입니다. 추가 정보는 Medi-Cal 치과 주 전체 이해관계자 회의 웹페이지에서 확인할 수 있습니다.
DHCS CalAIM MLTSS 및 듀얼즈 통합 워크그룹 회의
On August 18 at 10 a.m., DHCS will virtually host the CalAIM Managed Long-Term Services and Supports (MLTSS) and Duals Integration Workgroup meeting. Please register for the meeting, which is open to the public.
The meeting will serve as a stakeholder collaboration hub for CalAIM MLTSS and integrated care for dual eligible beneficiaries. It will also give stakeholders an opportunity to provide feedback and share information about policy, operations, and strategy for upcoming changes to Medicare and Medi-Cal. Agenda items include a summary of January 2023 enrollment changes; a presentation on the January 2023 transitions impacting dual eligible beneficiaries, including noticing, monitoring, and timelines; and an update on the Dementia Care Aware initiative.
Background materials, transcripts, and video recordings of the previous workgroup meetings, along with additional information about the workgroup, are posted on the CalAIM MLTSS and Duals Integration Workgroup webpage.
메디칼 치과 서비스를 위한 캘리포니아 스마일 캠페인
Smile, California is hosting Facebook Live presentations for Medi-Cal members in Spanish and English. The Spanish presentation will be held on August 24 at 1 p.m.; RSVP on Facebook. The English presentation will be held on August 26 at 1 p.m.; RSVP on Facebook. A Smile, California member outreach representative will deliver the Smile, your Medi-Cal benefits include dental! presentation, and a provider relations trainer will assist with answering audience questions.
치과 제공자를 위한 PAVE 포털 교육
On August 24 at 11 a.m., DHCS will host a webinar introduction to PAVE for dental providers. Beginning on October 31, DHCS will implement the PAVE portal for dental providers, offering a new mode for submitting dental provider enrollment applications and required documentation to DHCS. This allows applicants to use the Medi-Cal Provider e-Form Application, as DHCS will no longer accept paper applications once PAVE is implemented. For more information about the webinar, including the registration link for the August 24 training, please view this Medi-Cal Dental Provider Bulletin. The PAVE demonstrations will be recorded and posted on the DHCS PAVE webpage.
DHCS 가족계획국 이해관계자 회의
On August 24, DHCS will host a virtual family planning stakeholder meeting. The link to the meeting will be available on the Office of Family Planning webpage prior to the meeting.
둘라 혜택 이해관계자 회의
On August 24, DHCS will host a virtual stakeholder workgroup meeting about adding doula services as a covered Medi-Cal benefit. The meeting is open to the public. DHCS will engage with workgroup members on policy development details that will be reflected in the Medi-Cal provider manual and other policy guidance documents. All interested stakeholders may listen to the workgroup discussion regarding stakeholder feedback and provide input via email. DHCS will also share an update on the status of formal submission of the SPA to CMS. The link for the stakeholder meeting will be available on the doula webpage prior to the meeting.
CalAIM 웨비나: 향상된 케어 관리(ECM) 및 커뮤니티가 회원 참여를 지원합니다.
On August 25 at 1:30 p.m., DHCS will host an all-comers webinar on CalAIM ECM and Community Supports member engagement. Topics for this session will include provider and member communications, referrals, outreach, and enrollment. This event is part of a series of technical assistance and informational sessions focused on supporting implementation of ECM and Community Supports. Throughout the series, DHCS leaders will be joined by presenters from MCPs, providers, and CBOs implementing CalAIM.
Advance registration for CalAIM webinar is required. Participants are invited to submit questions by August 22 to CalAIMECMILOS@dhcs.ca.gov. Attendees will also have the opportunity to ask questions during the webinar. An additional “Office Hours” event will be held on September 1 at 2 p.m. (see below) for attendees to ask any other questions not covered during the webinar.
CYBHI 월간 웨비나
On August 29 at 3 p.m., DHCS will virtually host a webinar to keep stakeholders apprised of DHCS’ progress in implementing various work streams of the 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 education and other cross-sector partners. CYBHI Monthly Webinar advance registration is required.
CalAIM 업무 시간: 회원 참여를 지원하는 ECM 및 커뮤니티
On September 1 at 2 p.m., DHCS will virtually host an “Office Hours” discussion on CalAIM ECM and Community Supports member engagement. As a follow-up to the August 25 webinar on this topic, this question and answer session will cover provider and member communications, referrals, outreach, and enrollment. This event is part of a series of “Office Hours” events focused on answering implementation questions from the field.
Advance registration is required. Participants are invited to submit questions by August 29 to CalAIMECMILOS@dhcs.ca.gov. Attendees will also have an opportunity to ask questions during the session.