인기 뉴스​​ 

CalAIM 데모 수정 승인​​ 

On August 23, the Centers for Medicare & Medicaid Services (CMS) approved an amendment to the California Advancing and Innovating Medi-Cal (CalAIM) Section 1115 demonstration waiver, allowing the state to implement county-based model changes in its Medi-Cal managed care program. The amendment includes expenditure authority to limit the choice of managed care plans (MCPs) in non-rural areas. This authority would apply in the metro, large metro, and urban counties intending to participate in the County Organized Health System (COHS) or Single Plan models.​​ 

For rural counties, CMS approved an amendment to the CalAIM Section 1915(b) waiver on June 26 to limit plan choice in rural counties to participate either in the COHS or Single Plan models. These county-based model changes will go into effect on January 1, 2024. Twelve counties will become COHS and three will become Single Plan model counties. For more information about all counties, their current and 2024 model type, and the MCPs operating in the county, please see the MCP county table.​​ 

프로그램 업데이트​​ 

Medi-Cal Rx​​ 

8월 22일, Medi-Cal Rx 고객 서비스 센터는 가입자, 처방자, 약사 및 일반인을 위한 대화형 음성 인식 개선 기능을 구현했습니다. 향상된 기능에는 통화 설문조사, 통화를 간소화하는 기본 메뉴, 상담원에게 통화 이유를 알려주는 코드, 발신자가 여러 셀프 서비스 항목을 확인할 수 있도록 기본 메뉴로 돌아가는 루프백, 개선된 안내 언어 및 배치 등이 포함되어 있습니다.​​ 

On August 16, a New Start PA Reminder Alert was published about the prior authorization requirements that will be reinstated beginning on September 22 for new start enteral nutrition products for members 22 years of age and older.​​ 

어린이용 메디칼 & 청소년 정보 메일링​​ 

On August 25, DHCS distributed an informational mailing to Medi-Cal fee-for-service (FFS) members and/or their parents or guardians about the federal Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services, known in California as Medi-Cal for Kids & Teens. The FFS mailing includes: (1) Medi-Cal for Kids & Teens brochures to improve member understanding of how Medi-Cal works for children, teens, and young adults, what it covers, and its role in preventive care screening, diagnosis, and treatment. The child brochure is for children up to age 12, and the teen brochure is for ages 12-20; and (2) “Medi-Cal for Kids & Teens: Your Medi-Cal Rights” guide to help members under age 21 understand their Medi-Cal benefits and their recourse if medically necessary care is denied, delayed, reduced, or stopped. The materials, including translations, are posted on the Medi-Cal for Kids & Teens webpage.​​ 

팀에 합류하세요​​ 

DHCS는 재정, 인사, 법무, 감사, 건강 정책, 정보 기술 팀에서 채용을 진행 중입니다. 자세한 내용은 CalCareers 웹사이트를 참조하세요.​​ 

DHCS is dedicated to providing equitable access to quality health care, leading to a healthy California for all. DHCS’ goals and objectives express the tremendous work DHCS is leading to transform our health care system and reflect the organizational culture we are building together.​​ 

예정된 이해관계자 회의 및 웨비나​​ 

트라우마 정보에 기반한 관행을 생식 건강 서비스 웨비나에 통합하기​​ 

8월 30일 오후 12시부터 1시 30분까지 DHCS와 캘리포니아 예방 교육 센터는 생식 건강 서비스에 트라우마 정보에 기반한 관행을 통합하는 웨비나를 개최합니다. 트라우마 정보 기반 치료는 효과적인 치료를 제공하기 위해 고객의 삶의 경험을 이해해야 할 필요성을 인정하며 환자 참여, 치료 순응도 및 건강 결과를 개선할 수 있는 잠재력을 가지고 있습니다. 라이브 웨비나에 참석하지 못한 분들을 위해 웨비나 대본 및 녹화본과 추가 자료는 Family PACT 웹사이트에서 확인할 수 있습니다.​​ 

인디언 부족 및 인디언 보건 프로그램 지정자 분기별 웨비나​​ 

On August 30, from 2 to 3 p.m., DHCS will host a webinar (advance registration required) for tribal and Indian health program representatives to provide feedback on DHCS initiatives with specific impact to tribes, Indian health programs, and American Indian Medi-Cal members. The webinar will provide information about State Plan Amendments, waivers, and demonstrations proposed for submission to CMS, including the Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) Medicaid section 1115 demonstration and transitional rent services amendment to the CalAIM section 1115 demonstration. Email questions or comments to TribalAffairs@dhcs.ca.gov.​​ 

형평성 및 실무 혁신 결제 프로그램 웨비나​​ 

On August 30, from 3 to 4 p.m., DHCS will host an Equity and Practice Transformation Payments Program Webinar (advance registration required) to share an update on the Equity and Practice Transformation Payments Program, which is a one-time $700 million primary care practice transformation program initiative to advance health equity and population health and invest in upstream care models. Details about the Provider Directed Payment Program will be discussed during the webinar; the program application and other materials will be posted on the DHCS website in the future. Please email ept@dhcs.ca.gov with any questions.​​ 

DHCS 커버리지 앰배서더: 트레이너 웨비나 교육​​ 

On August 31, from 10 to 11:30 a.m., DHCS will host a webinar on Coverage Ambassadors: Train the Trainer. The webinar will serve as a training session for Coverage Ambassadors to better assist their communities as California resumes standard Medi-Cal operations and communicates the importance of members renewing their Medi-Cal coverage. The webinar will also describe the resources available and how to use them. For more information, visit the Coverage Ambassadors Coverage Ambassadors webpage. Join the Coverage Ambassadors mailing list to receive the latest information and updated toolkits as they become available.​​ 

요양 시설 재정 개혁 웨비나​​ 

On September 7, from 2 to 3 p.m., DHCS will host a virtual stakeholder webinar to discuss the development of the Skilled Nursing Facility Workforce Standards Program and provide updates on other nursing facility financing reform programs authorized by Assembly Bill 186 (Chapter 46, Statutes of 2022). Stakeholder input will be accepted. Additional information is available on the Nursing Facility Financing Reform (AB 186) webpage.​​ 

가족 및 지역사회 파트너를 위한 어린이 보청기 보장 프로그램(HACCP) 웨비나​​ 

On September 12, from 11 a.m. to 12 p.m., DHCS will host a HACCP webinar to share guidance with families and communities about applying for hearing aid coverage and helping children to maximizing their HACCP benefits once enrolled. DHCS welcomes newly interested families, those who are currently participating in HACCP, and community partners supporting families and children to join this webinar for program updates, tips, and a Q&A session. For more information, please visit www.dhcs.ca.gov/haccp.​​ 

Doula 구현 작업 그룹 회의​​ 

9월 14일 오후 12시부터 2시까지 DHCS에서 세 번째 둘라 이행 실무그룹 회의를 개최합니다. 회의를 들을 수 있는 링크는 8월 31일까지 Doula 서비스 메디칼 혜택 웹페이지에 게시됩니다. 이 회의에는 DHCS의 출산 관리 경로 제안과 둘라의 역할, 향후 회의 계획에 대한 보고가 포함됩니다. 이 작업 그룹은 교육 지원 프로그램을 통해 둘라 서비스의 가용성을 높이는 방법을 검토하고, 둘라 서비스의 장벽을 파악하여 최소화하며, 둘라 및 회원에 대한 지불 및 환급 지연 문제를 해결하는 일을 담당합니다.​​ 

의료 서비스 제공자 및 청각 전문가를 위한 웨비나​​ 

On September 14, from 12 to 1 p.m., DHCS will host a HACCP webinar to share information with providers to help pediatric patients and their families maximize HACCP benefits. The training session will address program requirements for families to apply for coverage and the claims submission process for audiologists, otolaryngologists, physicians, and their office staff. For more information, please visit www.dhcs.ca.gov/haccp.​​ 

놓친 경우를 대비하여​​ 

캘리포니아, 교도소 및 마약 법원에서 오피오이드 치료 접근성 확대​​ 

On August 22, DHCS announced it will expand Medication Assisted Treatment (MAT) to jails and drug courts it will expand Medication Assisted Treatment (MAT) to jails and drug courts. The $2.9 million in funding will go to 29 counties to support the development or expansion of access to MAT. By bringing county teams together in a learning collaborative, county agencies and providers serving justice-involved residents can more effectively coordinate and further build system capacity to ensure access to effective treatment and recovery supports. This expansion will better serve residents in need, and MAT, specifically, has been shown to reduce criminal activity and reincarceration to better serve the entire community.​​ 

주정부, CalHOPE 학교 이니셔티브 파트너십 확대​​ 

On August 24, DHCS announced the extension of the CalHOPE Schools Initiative through June 30, 2024 the extension of the CalHOPE Schools Initiative through June 30, 2024. The initiative provides free resources for school personnel, youth, and parents surrounding three powerful films that address student social-emotional and mental health needs: A Trusted Space: Redirecting Grief to Growth, Angst: Building Resilience, and Stories of Hope Shorts.​​ 

메디칼 재결정에 대한 국회 의사당 주간 의견서​​ 

8월 20일, Capitol Weekly는 LA Care의 CEO인 John Baackes의 의견을 실었습니다. LA 케어는 로스앤젤레스 카운티의 메디칼 매니지 케어 플랜 중 하나입니다. Baackes는 "이웃, 정부 파트너, 지역사회 옹호자 등 우리 모두가 친구와 이웃의 보험 가입을 위해 할 수 있는 모든 일을 해야 한다"고 Medi-Cal에 촉구했습니다.​​ 

메디칼 회원과 소통할 때 보험 혜택을 유지하는 데 도움이 되는 팁을 공유해 주세요. 자격 갱신일이 6월 또는 7월인 경우에도 아직 늦지 않았습니다. 메디칼 갱신 패킷을 오늘 지역 카운티 사무소에 반납하여 원래 갱신 날짜로 보험 혜택을 복원할 수 있습니다. 또한 지난 몇 년 동안 이사했거나 연락처 정보가 변경된 메디칼 가입자는 지역 카운티 사무소에 현재 정보가 있는지 확인하여 중요한 갱신 정보를 받을 수 있도록 해야 합니다. 그리고 가입자가 우편으로 노란색 봉투에 담긴 메디칼 갱신 패킷을 받은 경우, 갱신 서류를 반송하여 본인과 가족을 보장받을 수 있도록 신속하게 조치를 취해야 합니다.​​