3월 24, 2025
인기 뉴스
캘리포니아, 겸상 적혈구 질환 치료 확대를 위한 신청서 제출
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.
전통적 건강 관리 관행의 혜택 구현
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.”
프로그램 업데이트
지금 이용 가능: 폐쇄 루프 추천 구현 지침에 대한 웨비나 자료
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 요건이 추천 추적, 지원 및 모니터링 노력을 간소화하여 회원 추천 프로세스를 개선하는 방법.
- CLR 요건이 의료 맞춤형 식사 커뮤니티 지원을 받는 회원에게 어떻게 도움이 되는지에 대한 사용 사례 시나리오의 예입니다.
캘리포니아 발전 및 혁신 메디칼(CalAIM) 인구 건강 관리 이니셔티브에 대한 질문이나 의견이 있는 경우 DHCS에 문의( PHMSection@dhcs.ca.gov)하세요.
팀에 합류하세요
DHCS는 재무, 인사, 약국, 행동 건강 및 기타 팀에서 채용을 진행 중입니다. 자세한 내용은 CalCareers 웹사이트를 참조하세요.
예정된 이해관계자 회의 및 웨비나
DHCS는 이벤트 캘린더에 예정된 공개 미팅을 게시합니다.
커버리지 앰배서더 웨비나
3월 25일 오전 11시부터 오후 12시(태평양 표준시)까지 DHCS는 의료 서비스 옵션 및 Medi-Cal 업데이트에 대한 정보를 제공하는 Coverage Ambassador 웨비나(사전 등록 필요)를 개최합니다. 홍보대사는 모두를 위한 건강한 캘리포니아를 만드는 데 초점을 맞춘 Medi-Cal 혜택, 가입 정보 및 새로운 프로젝트에 대한 소식을 널리 알리는 데 도움을 줍니다. 자세한 내용은 커버리지 앰배서더 웹사이트를 방문하거나 커버리지 앰배서더를 신청하여 정기적인 업데이트를 받아보세요.
관리형 장기 서비스 및 지원(MLTSS) 및 듀얼즈 통합 작업 그룹 회의
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.
의료 제공자 및 청각 전문가를 위한 어린이 보청기 보장 프로그램(HACCP) 웨비나
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.
놓친 경우를 대비하여
지금 신청하세요: 접근성 제공 및 보건 혁신(PATH) 역량 및 인프라 전환, 확장 및 개발(CITED) 4라운드 지원서 접수
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 4라운드 펀딩 신청 마감일은 2년 2025월 일 오후 11시 59분(태평양 표준시)입니다. 지침 문서와 신청서는 PATH CITED 웹페이지에서 확인할 수 있습니다. 질문이 있으시면 cited@ca-path.com 으로 보내주세요.