인기 뉴스​​ 

아동 및 청소년을 위한 향상된 케어 관리(ECM) 중점 대상 인구(POF) 스포트라이트​​ 

On November 3, DHCS published the ECM for Children and Youth POF Spotlight, which is designed to help contracted and prospective ECM providers serving children and youth develop and enhance their ECM models. It is also intended to support provider organizations that are considering if ECM for children and youth is right for them. The new resource outlines key ECM policies for the children and youth POFs, including areas where plans can leverage presumptive authorization; member scenarios that illustrate how to deliver ECM for the children and youth POFs, with examples of how Community Supports can be integrated to best serve children, youth, and caregivers; and guidance on how prospective providers can get started, with a collection of the key resources and funding opportunities.

DHCS is committed to providing technical assistance and support to California’s growing network of ECM providers. This is the first in a series of ECM spotlights that DHCS plans to release over the coming months to support stakeholders seeking more details on how providers tailor ECM to meet the needs of different POFs. For more information, visit the ECM and Community Supports webpage.​​ 

프로그램 업데이트​​ 

메디칼 및 위탁 보호 업데이트​​ 

DHCS developed a resource to provide updates on foster care youth in Medi-Cal. The resource covers changes to managed care for the child welfare population in 2024, Enhanced Care Management and Community Supports transition policies, the 2024 Medi-Cal managed care plan (MCP) contract and memorandum of understanding requirements, and Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment child and youth components.​​ 

온라인으로 제공되는 Doula 서비스 업데이트​​ 

11월 3일, DHCS는 Doula 서비스를 Medi-Cal 혜택 웹페이지로 업데이트했습니다. 업데이트된 웹 페이지에는 DHCS 의료 책임자인 Karen Mark 박사가 새로 발표한 둘라 서비스에 대한 상임 권고안을 포함하여 Medi-Cal 가입자와 둘라 제공자를 위한 유용한 리소스가 포함되어 있습니다. 이 상임 권고안은 예방적 서비스로서 둘라 서비스를 권장하는 연방 요건을 충족합니다.

웹페이지 업데이트에는 둘라 및 Medi-Cal 가입자를 위한 새로운 자주 묻는 질문, 승인된 총 둘라 제공자 신청 및 등록된 개별 제공자 수, 출산 및 산모 결과에 대한 둘라 서비스의 혜택을 뒷받침하는 증거에 대한 정보도 포함되어 있습니다. 둘라 서비스에 대한 질문이 있으면 DoulaBenefit@dhcs.ca.gov 으로 이메일을 보내주세요.​​ 

팀에 합류하세요​​ 

DHCS에서 채용 중입니다! DHCS에는 다음과 같은 기회가 있습니다:​​ 

• Chief of the Financial Management Division within Fiscal (final filing date (FFD) is November 15). This executive role develops policies and procedures to ensure fiscal integrity, transparency, and accountability of approximately $150 billion in annual state and federal funding for DHCS.​​ 

• Behavioral Health Policy Medical Consultant II within Behavioral Health (FFD is November 27). This position provides clinical expertise and strategic advice to DHCS Behavioral Health leadership on the development and implementation of policy and initiatives designed to strengthen behavioral health care access, quality, and service delivery.​​ 

• Senior Assistant Chief Counsel for Fiscal and Financing within the Office of Legal Services (FFD is November 28). This position is responsible for complex legal counsel and litigation strategy formulation regarding DHCS fiscal, financial management, and health care policy.​​ 

• 법무 서비스 사무소 내 의료 서비스 전달 시스템 담당 수석 고문 변호사 (FFD는 11월 30일). 이 직책은 의료 서비스 전달 체계의 다양한 측면에 관한 복잡한 법률 자문 및 소송 전략 수립을 담당합니다.​​ 

 DHCS is also hiring for our human resources, auditing, health policy, and information technology teams. For more information, please visit the CalCareers website.​​ 

예정된 이해관계자 회의 및 웨비나​​ 

커뮤니티를 보호하세요: 학교 및 가족 웨비나​​ 

11월 16일 오후 2시부터 3시까지 DHCS에서 ' 커뮤니티 보호'에 관한 웨비나를 개최합니다: 학교와 가족 (사전 등록 필요). 이 웨비나에서는 학교 파트너에게 학생과 그 가족이 Medi-Cal 보험을 갱신하는 데 도움이 되는 중요한 정보를 제공합니다. 이 웨비나에서는 학령기 자녀를 둔 가족을 참여시키기 위한 지원 리소스와 모범 사례도 소개합니다.​​ 

CBO 및 LHJ를 위한 Medi-Cal 등록 요건 및 절차 웨비나 보기​​ 

11월 17일 오전 10시부터 11시 30분까지 DHCS는 웨비나 (사전 등록 필요)를 통해 공개 이해 관계자 공청회를 개최하여 커뮤니티 보건 종사자 및/또는 천식 예방 서비스를 제공하는 커뮤니티 기반 기관(CBO) 및 지역 보건 관할 구역(LHJ) 제공자를 위한 Medi-Cal 가입 요건 및 절차에 관한 규제 제공자 공고를 논의할 예정입니다(사전 등록 필요). 1월 9, 2024부터 Medi-Cal 서비스별 수가 프로그램 등록을 요청하는 CBO 및 LHJ 제공자는 제공자 신청 및 등록 검증(PAVE) 온라인 등록 포털을 통해 신청서를 제출할 수 있습니다.​​ 

웨비나 채팅을 통해 공청회 중에 서면 의견, 질문 또는 제안을 제출할 수 있습니다. 참석할 수 없는 경우 11월 17일 오후 5시까지 서면 의견을 제출해야 공개를 고려할 수 있습니다. 서면으로 의견을 제출할 때는 댓글에 댓글 작성자와 해당 단체/협회의 신원을 모두 명시해야 합니다. 서면 의견은 DHCSPEDStakeholder@dhcs.ca.gov 으로 제출해야 합니다. 접수된 대중의 의견을 바탕으로 DHCS는 Medi-Cal 및 DHCS 웹사이트에 최종 공지를 게시할 예정입니다.​​ 

CalAIM 발달장애인 중간 치료 시설(ICF/DD) 카브인 청구 및 결제 웨비나​​ 

On November 17 at 1 p.m., DHCS will host the fourth in a series of educational webinars on the California Advancing and Innovating Medi-Cal (CalAIM) ICF/DD carve-in (advance registration required). These webinars outline changes to the ICF/DD carve-in policy requirements. Starting on January 1, 2024, all Medi-Cal MCPs will be required to cover and coordinate institutional long-term care for members residing in an ICF/DD. The webinar series will feature several topics, including ICF/DD carve-in 101, directed payment policy and payment requirements, the per diem rate, accommodation code changes, and best practices for billing and payment. ICF/DD home, Regional Center, and Medi-Cal managed care representatives are encouraged to attend. All webinars are open to the public.​​ 

If there are specific questions you would like addressed during the webinar, please submit them in advance using this registration form or by emailing them to LTCtransition@dhcs.ca.gov. Webinar materials, including recordings, and additional details about upcoming webinars are posted on the CalAIM ICF/DD Long-Term Care Carve-In webpage.​​ 

요양 시설 재정 개혁 웨비나​​ 

On November 17, from 3 p.m. to 4 p.m., DHCS will hold a virtual stakeholder webinar (advance registration required) to discuss the development of the Skilled Nursing Facility Workforce Standards Program, Accountability Sanctions Program, and Workforce & Quality Incentive Program (WQIP) authorized by Assembly Bill 186 (Chapter 46, Statutes of 2022). This meeting will also provide an opportunity for stakeholder input. Additional information is posted on DHCS’ Nursing Facility Financing Reform (AB 186) webpage.​​ 

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

On November 28, from 11 a.m. to 12 p.m., DHCS will host a HACCP webinar (advance registration required) to share guidance with families and communities about applying for hearing aid coverage and helping children to maximize their HACCP benefits once enrolled. DHCS welcomes newly interested families, as well as families currently participating in HACCP, and community partners supporting families and children to join this webinar for program updates, tips, and a question-and-answer session. For more information, please visit www.dhcs.ca.gov/haccp.​​ 

의료 서비스 제공자 및 청각 전문가를 위한 HACCP 웨비나​​ 

On December 19, from 12 to 1 p.m., DHCS will host a HACCP webinar (advance registration required) 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.​​ 

메디칼 자산 제거 웨비나​​ 

11월 29일 오후 1시 30분부터 2시 30분까지 DHCS는 1년 2024월부터 시행되는 비수정 총소득(MAGI) Medi-Cal 프로그램의 자산 제거에 관한 웨비나를 개최합니다. 이 이니셔티브가 시행되면 장기 요양 및 메디케어 저축 프로그램을 포함한 모든 비 MAGI 프로그램에 대한 자산 테스트가 사라집니다. 웨비나에서는 자산 제거에 대한 배경 정보, 실행 계획, 절차 변경 사항, 홍보 자료 등을 제공합니다. 자세한 내용은 비매기 메디칼의 자산 한도 변경 웹페이지에서 확인할 수 있습니다.​​ 

CalAIM 관리형 장기 서비스 및 지원(MLTSS) 및 듀얼즈 통합 워크그룹 가상 회의​​ 

On November 30 at 10 a.m., DHCS will virtually host the CalAIM MLTSS and Duals Integration Workgroup meeting (advance registration required). The workgroup serves as a stakeholder collaboration hub for CalAIM MLTSS and integrated care for dual eligible members, and allows stakeholders to provide feedback and share information about policy, operations, and strategy for upcoming changes to Medi-Cal and Medicare.​​ 

Agenda topics will include reminders about the 2024 Medi-Cal transitions and noticing timelines, updates on Medi-Medi Plan outreach and the 2024 Dual Eligible Special Needs Plan Policy Guide development, July 2023 duals enrollment data, a spotlight presentation on the CalAIM recuperative care Community Support, and a presentation on the continuous coverage unwinding.​​ 

Background materials, transcripts, and video recordings of previous workgroup meetings, along with additional information about the workgroup, are posted on the CalAIM MLTSS and Duals Integration Workgroup webpage. For questions or comments, please email DHCS at info@calduals.org.​​ 

메디칼 성인 확장 웨비나​​ 

On December 4, from 11 a.m. to 12 p.m., DHCS will host a webinar on the adult expansion of Medi-Cal (advance registration required) for CBOs, MCPs, providers, and other interested stakeholders, including those representing consumers, immigration, health care, legal aid, and immigrant adults. DHCS is implementing this expansion pursuant to Senate Bill 184 (Chapter 47, Statutes of 2022) on January 1, 2024. When implemented, the expansion will provide individuals 26-49 years of age with full scope Medi-Cal benefits, regardless of citizenship or immigration status, if they meet all other Medi-Cal eligibility criteria.​​ 

The webinar, which will be live interpreted in Spanish, will provide background information about the expansion, implementation planning, noticing, outreach, and more. Individuals may also submit questions or request to register for the webinar by sending an email to AdultExpansion@dhcs.ca.gov.​​ 

놓친 경우를 대비하여​​ 

섹션 1115 데모: BH-CONNECT 및 CalAIM 과도기적 임대료 수정안​​ 

On October 20, DHCS submitted to Centers for Medicare & Medicaid Services (CMS) the new Section 1115 demonstration request, entitled the California Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) demonstration, and the proposed amendment to the CalAIM Section 1115 demonstration related to transitional rent services. Additionally, the federal public comment period will be open for BH-CONNECT and CalAIM transitional rent services from October 27 through November 26, 2023.​​ 

2024년 1월 Medi-Cal MCP 전환​​ 

As part of Medi-Cal transformation, some MCPs are changing on January 1, 2024, and approximately 1.2 million members will have new health plan options and/or will need to transition to new MCPs. Changing MCPs will not affect Medi-Cal member coverage or benefits. Members who transition to a new MCP are receiving notices about the transition. DHCS developed several resources to support members, providers, and other stakeholders with the transition, including the Managed Care Plan Transition Member webpage with a county “lookup” tool, links to member notices sent by Medi-Cal about MCP changes, frequently asked questions, and a Contact Us page for members to learn more about health plans and provider choices. There are also transition resources for providers and MCPs and stakeholders. More information about the transition is available in the 2024 Managed Care Plan Transition Policy Guide and Medi-Cal Eligibility Division Information Letter Number I 23-54.​​