인기 뉴스​​ 

수익 안정성 및 계획을 지원하는 새로운 행동 건강 서비스법(BHSA) 보고서​​ 

DHCS released the BHSA Revenue Stability Workgroup Report with recommendations to reduce the variance of county Behavioral Health Services Funds (BHSF). The recommendations are intended to help counties manage revenue more consistently, maintain services through economic ups and downs, and bring greater predictability and accountability to local behavioral health care funding.​​ 

The BHSA Revenue Stability Workgroup, comprising state leaders and counties, was required to develop and recommend solutions to reduce BHSA revenue volatility and propose appropriate prudent reserve levels to support the sustainability of county programs and services. It reviewed and analyzed current and historical revenues generated by the MHSA and the BHSA and prudent reserve levels to develop the recommendations.​​ 

The State Controller’s Office will continue to follow the current process to distribute BHSA local assistance funds to counties monthly. The goal is to balance local assistance revenue allocation and program stability, helping counties effectively plan and provide critical behavioral health services during revenue downturns. Highlights include:​​ 

• 연간 지출 한도는 인플레이션을 고려하여 조정된 3년 평균을 기준으로 합니다.​​ 
• 새로운 예비금 한도(카운티 규모에 따라 10~15%).​​ 
• 2026~2029년 사이에 한 번만 초과 적립금을 사용해야 합니다.​​ 
• 수익이 감소할 경우 예산을 유연하게 조정할 수 있습니다.​​ 
• 공개 보고 및 커뮤니티 의견 수렴을 의무화하여 투명성을 높입니다.​​ 

This approach supports California’s Mental Health for All vision by promoting stability, transparency, and community-centered behavioral health care. State legislation is required to enact recommendations from the BHSA Revenue Stability Workgroup Report.​​ 

메디칼 회원의 요구 사항을 충족하면서 조기 비용 효율성을 보여주는 커뮤니티 지원​​ 

DHCS recently submitted to the Centers for Medicare & Medicaid Services (CMS) its Community Supports, or In Lieu of Services (ILOS), Annual Report[TO1] , which reviews the progress and impact of Medi-Cal Community Supports in 2024. For the first time, the report also includes a cost-effectiveness analysis for 2023. The report highlights key achievements, such as reduced emergency room visits, hospitalizations, and long-term care use, pointing to early evidence of both improved health outcomes and reduced costs when compared to the services they are replacing, such as inpatient, emergency department, and long-term care services. Of the 12 Community Supports studied, nine are already proving cost-effective, and the remaining three are expected to prove to be cost-effective over time.​​ 

The report also outlines operational improvements made by DHCS and managed care plans (MCP) to expand services, grow provider networks, and support implementation. While progress has been significant, the report also identifies ongoing challenges and opportunities for further improvement, ensuring these services continue to evolve to meet the needs of Medi-Cal members.​​ 

프로그램 업데이트​​ 

Medi-Cal 상업용 MCP 조달 업데이트​​ 

DHCS는 차기 상업용 메디칼 MCP 조달을 최소 2년 연기할 예정입니다. 차기 MCP 경쟁 입찰은 2029년 이후에 시작될 예정이며, 계약 발효는 2031년 이후에나 가능할 것으로 예상됩니다. DHCS는 이전에 상업용 MCP 재조달이 5년마다 한 번씩 실시될 것이라고 밝힌 바 있습니다. 이 가정된 일정에 따르면 DHCS는 2027년에 계약 유효일인 1월 1, 2029에 대한 제안 요청서(RFP)를 발표해야 했을 것입니다.​​ 

The additional time will allow DHCS to focus on critical California Advancing and Innovating Medi-Cal (CalAIM) initiatives. It will also help maintain stability for members and support ongoing improvements to care quality and access, while also supporting the long-term success of the Medi-Cal managed care program.​​ 

In accordance with current policy, MCP contracts will be renewed annually following the contractual requirements identified in Exhibit E, 1.1.15 of the 2024 Managed Care Boilerplate Contract. Current MCP contracts will be extended from January 1, 2026, to December 31, 2026, by the established annual process. DHCS remains committed to fostering an inclusive, flexible, and responsive process that supports the Medi-Cal program and ensures continued equitable access to high-quality care for Californians. Please visit the Medi-Cal Managed Care webpage for more information.​​ 

치과 매니지드 케어 전환​​ 

During the week of May 26, DHCS will mail a 30-day notice to about 350,000 Medi-Cal members in Sacramento and Los Angeles counties to notify them of upcoming changes to their dental service delivery, effective July 1, 2025. The member notice explains what is changing, if the member needs to make a plan choice, the member’s continuity of care protections, and other important information, and will include a Medi-Cal managed care enrollment packet.​​ 

Members in Sacramento County who are currently enrolled in Access Dental Plan or dental fee-for-service (FFS) must select a new Dental Managed Care plan, while members in Los Angeles County who do not choose a Dental Managed Care plan will remain in FFS. Members currently enrolled with Health Net or Liberty will not be affected by these changes. Additionally, changing Dental Managed Care plans will not affect Medi-Cal coverage or benefits.​​ 

메디칼 헬스케어 옵션(Medi-Cal Health Care Options)은 관리형 의료 가입 안내 자료를 받은 회원들을 대상으로 전화 캠페인을 진행하고 있습니다. 이러한 통화에서 HCO 담당자는 이용 가능한 치과 관리형 의료 플랜을 검토하고 질문에 답변하며 회원이 선택한 플랜에 전화로 가입할 수 있도록 지원합니다. DHCS는 회원들이 치과 관리 의료 전환에 관한 공지 및 기타 정보를 확인할 수 있도록 치과 전환 회원 공지 웹페이지를 개발했습니다.​​ 

약국 제공자를 위한 Medi-Cal 등록 요건 및 절차​​ 

2023년 8월 1, 2025부터 유효한 임상 실험실 개선 수정안(CLIA) 면제 인증서와 현재 캘리포니아 임상 실험실 등록 인증서를 보유한 약국 제공자는 캘리포니아 주 약사 위원회에서 정의하고 사업 및 전문직 법규 4052.4절에 따라 승인된 약사의 업무 범위 내에서 제공되는 CLIA 면제 테스트에 대해 청구할 수 있습니다. 약국 제공자는 모든 관련 서류와 함께 Medi-Cal 제공자 등록 온라인 신청서를 제출하여 Medi-Cal 프로그램에 등록해야 합니다.​​ 

On June 10, from 10 to 11 a.m. PDT, DHCS will hold a public stakeholder hearing via webinar (advance registration required) to discuss the draft regulatory provider bulletin entitled, “Medi-Cal Enrollment Requirements and Procedures for Pharmacy Providers that Hold a Clinical Laboratory Improvement Amendments (CLIA) Certificate of Waiver.”​​ 

서면 의견, 질문 또는 제안은 청문회 중 웹 세미나 채팅을 통해 제출할 수 있습니다. 참석이 어려우신 분들은 6월 10일 오후 5시(태평양 표준시)까지 서면 의견을 제출해 주시면 게재 여부를 검토하겠습니다. 서면 의견을 제출하실 때에는 의견 작성자와 소속 기관/협회를 모두 명시해 주시기 바랍니다. 의견이 있으시면 DHCSPEDStakeholder@dhcs.ca.gov 로 서면 의견을 제출해 주십시오. 접수된 의견을 바탕으로 DHCS는 최종 공지사항을 메디칼 제공업체 웹사이트와 DHCS 제공업체 등록 부서 웹사이트에 게시할 예정입니다.​​ 

팀에 합류하세요​​ 

DHCS는 재능 있고 의욕적인 인재를 찾고 있습니다:​​ 

• 캡티브 요금 개발 부서 책임자. 최고 책임자는 Medi-Cal 매니지 케어 플랜 및 노인 종합 케어 프로그램의 요금 책정 활동을 주도합니다. 활동에는 보험요율 설정을 위한 보험수리적 방법을 구현하고 환급을 위한 정책 및 프로토콜의 개발과 시행을 감독하는 것이 포함됩니다. 또한 최고 책임자는 재무 방법론이 양질의 의료 서비스를 효율적으로 제공하고 주 및 연방 법률, 규정 및 규칙을 준수하는 데 부합하는지 확인합니다. 신청서는 5월 30일까지 제출해야 합니다.
  ​​ 

• Assistant Deputy Director (ADD), Enterprise Technology Services (ETS). This new ADD role will build collaborative working relationships with DHCS Executive Staff, program partners, and external stakeholders, and assist with leading DHCS’ IT programs and services. Additionally, the ADD will play a vital role in leading the development and implementation of IT policies, system architecture, security, improvements, and solutions for DHCS programs, including Medi-Cal and behavioral health. Applications must be submitted by June 2.​​ 

DHCS는 메디칼 관리 의료, 데이터 분석, 메디칼 자격 심사 및 기타 팀에서 직원을 채용하고 있습니다. 더 자세한 정보를 원하시면 CalCareers 웹사이트를 방문하세요.​​ 

예정된 이해관계자 회의 및 웨비나​​ 

DHCS posts upcoming public meetings on the Calendar of Events. DHCS provides free assistive services, including language interpretation, real-time captioning, and alternate formatting of meeting materials. To request services, please email DHCS at the appropriate contact email address at least ten working days before the meeting.​​ 

커버리지 앰배서더 웨비나 시리즈: 출산 관리 경로​​  

On May 29, from 11 a.m. to 12 p.m. PDT, DHCS will hold a Coverage Ambassador webinar that will focus on DHCS’ Birthing Care Pathway initiative (advance registration required). The webinar will provide information about maternity services for pregnant and postpartum Medi-Cal members from conception through 12 months postpartum and review highlights from the Birthing Care Pathway Report released on February 4. This initiative helps to ensure Medi-Cal members have access to high-quality, equitable care to improve maternal health outcomes and reduce disparities. Coverage Ambassadors will also learn about DHCS’ social media platforms, which offer up-to-date information on relevant topics that can benefit both Coverage Ambassadors and Medi-Cal members. Simultaneous interpretation in Spanish will be offered during the webinar.​​ 

놓친 경우를 대비하여​​ 

신청 요청(RFA): 유연한 주택 보조금 풀​​  

On May 7, DHCS announced the Flexible Housing Subsidy Pools (“Flex Pools”) RFA. DHCS will select up to 10 local teams to participate in the Flex Pools TA Academy and receive Flex Pools planning grants of approximately $150,000. The launch of Medi-Cal Transitional Rent and Behavioral Health Services Act (BHSA) Housing Interventions creates an unprecedented opportunity to help people achieve better health outcomes through housing stability.​​ 

Flex Pools are intended to help counties and Tribal entities improve housing stability for individuals experiencing or at risk of homelessness. They are a locally designed model to coordinate rental assistance and make the best use of available housing supports, aligning the work of managed care plans, county behavioral health agencies, and other key partners in the homeless services and rehousing systems. Applications are due to DHCS by 5 p.m. PDT on June 13, 2025. Organizations selected will be notified in July 2025. To learn more and apply, please visit the DHCS Housing for Health website.​​ 

HCBA 면제 수정 신청 - 30일간의 공개 의견 수렴 기간​​ 

5월 12일, DHCS는 2025년 가정 및 지역사회 기반 대안(HCBA) 면제 개정안 초안을 게시하고 30일간의 공개 의견 수렴 기간을 거친 후, 최종 버전을 CMS에 재승인 요청하기 위해 제출할 예정입니다. HCBA 면제 조항에 따라 자격 요건을 충족하는 가입자는 원격 의료 시스템을 통해 승인된 서비스를 받을 수 있습니다. 면제 조항 개정안에 제안된 변경 사항은 다음과 같습니다.​​ 

• 원격 의료 서비스에 대한 지침과 기대치를 명확히 합니다.​​ 
• 발달장애인을 위한 중간 요양 시설-지속 간호(ICF/DD-CN)의 비환기 및 환기 의존적 혜택 및 환경이 메디케이드 주 플랜에서 장기 요양 혜택으로 전환됨에 따라 삭제됩니다.​​ 

This transition advances California’s efforts to comply with the federal Medicaid Home and Community-Based Settings (HCBS) Final Rule by reinforcing the delivery of services in integrated, community-based settings that support individual choice and autonomy.​​ 

DHCS invites all interested parties to review the amendments and comment instructions on the DHCS HCBA Waiver webpage under the HCBA Waiver Amendment Application – 30-Day Public Comment from May 12, 2025 – June 12, 2025 heading. All comments must be received by June 12, 2025. If you have any questions, please email hcbspolicy@dhcs.ca.gov.​​ 

메디케이드 주 계획 수정안(SPA) - 30일간의 공개 의견 수렴 기간​​  

On May 12, DHCS posted the ICF/DD-CN: Transition of Benefit/Setting SPA (SPA #25-0026) for a 30-day public comment period, prior to submitting the final version to CMS for approval. ICF/DD-CNs provide 24-hour personal care, developmental services, and nursing supervision for individuals with developmental disabilities who have continuous needs for skilled nursing care and have been certified by a physician and surgeon as warranting continuous skilled nursing care. This service is currently provided through the HCBA waiver. This SPA will transition the ICF/DD-CN benefit/setting from the HCBA waiver to the Medicaid State Plan as a long-term care setting. This transition advances California’s efforts to comply with the federal HCBS Final Rule by reinforcing the delivery of services in integrated, community-based settings that support individual choice and autonomy. All comments must be received by June 12, 2025. If you have any questions, please email PublicInput@dhcs.ca.gov.​​