ຂ່າວເດັ່ນ​​ 

Tyler Sadwith ຖືກເລືອກສໍາລັບໂຄງການ Medicaid Pathways​​ 

ສູນຍຸດທະສາດການດູແລສຸຂະພາບ (CHCS) ໄດ້ປະກາດໃນອາທິດນີ້ວ່າ Tyler Sadwith, ຮອງຜູ້ອຳນວຍການໂຄງການສຸຂະພາບທາງດ້ານພຶດຕິກຳຂອງ DHCS, ແມ່ນໜຶ່ງໃນ 20 ຜູ້ນຳອົງການ Medicaid ທີ່ກຳລັງເຕີບໃຫຍ່ຂະຫຍາຍຕົວຈາກທົ່ວປະເທດທີ່ໄດ້ຮັບການຄັດເລືອກໃຫ້ເຂົ້າຮ່ວມໃນຊັ້ນຮຽນທີສາມຂອງ ໂຄງການເສັ້ນທາງ Medicaid. ທ່ານ Tyler ຮັບຜິດຊອບໃນການນຳພາວາລະທີ່ມີຄວາມທະເຍີທະຍານຂອງ DHCS ເພື່ອຮັບປະກັນການບໍລິການດ້ານສຸຂະພາບຈິດພິເສດ ແລະ ການບໍລິການກ່ຽວກັບຄວາມຜິດປົກກະຕິຈາກການໃຊ້ສານເສບຕິດທີ່ມີຄຸນນະພາບສູງ ແລະ ສາມາດເຂົ້າເຖິງໄດ້ໃນ Medi-Cal ແລະ ໂຄງການສາທາລະນະອື່ນໆ. ລາວເປັນຜູ້ນຳທີມງານສຸຂະພາບທາງດ້ານພຶດຕິກຳຂອງກະຊວງໃນການພັດທະນາ ແລະ ການຈັດຕັ້ງປະຕິບັດໂຄງການຕ່າງໆທີ່ຖືກອອກແບບມາເພື່ອເສີມສ້າງການເຂົ້າເຖິງການດູແລສຸຂະພາບທາງດ້ານພຶດຕິກຳ, ຄຸນນະພາບ, ຄວາມສະເໝີພາບ ແລະ ການໃຫ້ບໍລິການສຳລັບສະມາຊິກ Medi-Cal ແລະ ຊາວຄາລິຟໍເນຍ 15.5 ລ້ານຄົນທີ່ໄດ້ຮັບໃຊ້ຜ່ານໂຄງການສາທາລະນະ.​​ 

ອັບເດດໂຄງການ​​ 

2024 ຄູ່ມືນະໂຍບາຍການຫັນປ່ຽນ Medi-Cal Managed Care Plan (MCP).​​ 

On September 29, DHCS released a revised version of the 2024 MCP Transition Policy Guide that includes DHCS policy and MCP requirements related to member transitions of Medi-Cal MCPs that take effect on January 1, 2024. The latest version includes a new MCP transition monitoring and oversight policy and transition-related requirements for incentive programs, as well as updates to all other sections. The policy guide will be updated regularly to keep MCPs informed of new and developing guidance.​​ 

ການໃຫ້ການເຂົ້າເຖິງ ແລະ ການຫັນປ່ຽນຕະຫຼາດການຊ່ວຍເຫຼືອດ້ານວິຊາການ (TA) ດ້ານສຸຂະພາບ (PATH) – ນະໂຍບາຍການເຂົ້າເຖິງຜູ້ຮັບ TA ທີ່ໄດ້ຮັບການປັບປຸງ​​ 

On September 29, DHCS announced the revised policy for accessing free TA resources available through the PATH TA Marketplace. Effective immediately, all approved TA recipients may now access both off-the-shelf TA projects and hands-on TA projects in all seven TA domains, regardless of if they are contracted with a MCP or other eligible entity to provide Enhanced Care Management (ECM) and/or Community Supports. Learn how free TA services offered through the PATH TA Marketplace can strengthen your organization’s ability to build and deliver quality ECM and Community Supports by visiting the PATH TA Marketplace webpage. Please submit any questions regarding the revised access policy to ta-marketplace@ca-path.com.​​ 

PATH TA Marketplace ຮອບທີ 3 ຄໍາຮ້ອງສະຫມັກຜູ້ຂາຍ​​ 

On October 1, DHCS will open the PATH TA Marketplace Round 3 vendor application window. The PATH TA Marketplace is a virtual marketplace for TA services, a one-stop-shop website where entities can access free TA resources from curated and approved vendors to help build their capacity to transform Medi-Cal. Organizations must apply to qualify as a TA Marketplace vendor before the October 31 deadline. Visit the TA Marketplace vendor webpage for more information and to apply. For questions, please email ta-marketplace@ca-path.com.​​ 

Medi-Cal Rx​​ 

On September 27 and 28, DHCS delivered the first presentations to update stakeholders on DHCS’ plans to advance Medi-Cal Rx. DHCS presented to the Pharmacy Directors meeting and the California Association of Medical Product Suppliers meeting. Also, on September 22, Reinstatement Phase 4, Lift 2 was successfully implemented. Drug cost ceiling and prior authorization for enteral nutrition and specific standard therapeutic classes for members 22 years of age and older have been reinstated. Additionally, as of September 22, the new COVID-19 vaccines appropriately reimburse the cost of the commercial vaccines (in addition to a $40 incentive fee).​​ 

ເຂົ້າຮ່ວມທີມງານຂອງພວກເຮົາ​​ 

DHCS ກໍາລັງຈ້າງສໍາລັບທີມງານງົບປະມານ, ຊັບພະຍາກອນມະນຸດ, ທາງດ້ານກົດຫມາຍ, ການກວດສອບ, ນະໂຍບາຍສຸຂະພາບ, ແລະທີມງານເຕັກໂນໂລຊີຂໍ້ມູນຂ່າວສານຂອງພວກເຮົາ. ສໍາລັບຂໍ້ມູນເພີ່ມເຕີມ, ກະລຸນາເຂົ້າໄປທີ່ ເວັບໄຊທ໌ CalCareers.​​ 

DHCS’ purpose is to provide equitable access to quality health care leading to a healthy California for all. DHCS’ goals and objectives reflect DHCS’ tremendous work to transform the state’s health care system and strengthen organizational excellence.​​ 

ກອງປະຊຸມຜູ້ມີສ່ວນກ່ຽວຂ້ອງ ແລະກອງປະຊຸມທາງເວັບທີ່ຈະມາເຖິງ​​ 

ກອງ​ປະ​ຊຸມ​ຜູ້​ມີ​ສ່ວນ​ຮ່ວມ​ທີ່​ສຸມ​ໃສ່​ການ​ບໍ​ລິ​ໂພກ (CFSW).​​ 

ໃນວັນທີ 6 ຕຸລາ, ແຕ່ເວລາ 10:00 ໂມງເຊົ້າ ຫາ 11:30 ໂມງເຊົ້າ, DHCS ຈະເປັນເຈົ້າພາບຈັດກອງປະຊຸມ CFSW. ຈຸດປະສົງຂອງ CFSW ແມ່ນເພື່ອໃຫ້ຜູ້ມີສ່ວນຮ່ວມມີໂອກາດທົບທວນ ແລະ ໃຫ້ຄໍາຄິດເຫັນກ່ຽວກັບເອກະສານສົ່ງຂໍ້ຄວາມຂອງຜູ້ບໍລິໂພກທີ່ຫຼາກຫຼາຍ. ເວທີປາໄສດັ່ງກ່າວຈະສຸມໃສ່ກິດຈະກຳທີ່ກ່ຽວຂ້ອງກັບການມີສິດໄດ້ຮັບ ແລະ ການລົງທະບຽນ ແລະ ສະເໜີການສົນທະນາເປີດກວ້າງກ່ຽວກັບນະໂຍບາຍ ແລະ ໜ້າທີ່ຂອງ Medi-Cal. ຜູ້ເຂົ້າຮ່ວມ CFSW ແມ່ນຜູ້ສະໜັບສະໜູນຈາກຊຸມຊົນປົກປ້ອງຜູ້ບໍລິໂພກ, ຕົວແທນຂອງສະມາຄົມຜູ້ໃຫ້ບໍລິການ, ແລະ ຜູ້ຊ່ຽວຊານໃນຂະແໜງການດູແລສຸຂະພາບ. ກະລຸນາສົ່ງອີເມວຫາຄຳຖາມໃດໆໄປທີ່ DHCSCFSW@dhcs.ca.gov. ເອກະສານການປະຊຸມທັງໝົດຈະຖືກລົງໃນ ໜ້າເວັບ DHCS CFSW ບໍ່ເກີນວັນທີ 4 ຕຸລາ.​​ 

CalAIM ICF/DD Carve-In Promising Practices Webinar​​ 

On October 6, from 9:30 to 11 a.m., DHCS will virtually host the third in a series of educational webinars (advance registration required) on the California Advancing and Innovating Medi-Cal (CalAIM) intermediate care facility for the developmentally disabled (ICF/DD) carve-in. The goal of these webinars is to provide stakeholders with an understanding of the ICF/DD carve-in policy requirements and how to support members when all Medi-Cal MCPs will be required to cover and coordinate institutional long-term care for members residing in an ICF/DD beginning on January 1, 2024. The webinar will focus on promising practices that MCPs, ICF/DD homes, and Regional Centers can consider as they prepare for the ICF/DD carve-in to take effect. Webinars are open to the public.​​ 

ລາຍລະອຽດເພີ່ມເຕີມກ່ຽວກັບການສຳມະນາທາງເວັບທີ່ຈະມາເຖິງແມ່ນມີຢູ່ໃນ ໜ້າເວັບການຫັນປ່ຽນ CalAIM ICF/DD Long-Term Care Carve-In. ສົ່ງອີເມວຫາຄຳຖາມ ຫຼື ຄຳເຫັນໄປທີ່ LTCtransition@dhcs.ca.gov.​​ 

ທາງເລືອກການຄຸ້ມຄອງ Medicare ໃນຄາລິຟໍເນຍ: Webinar​​ 

On October 11 at 1 p.m., DHCS and the California Department of Aging will jointly host a webinar entitled, “Navigating Medicare Coverage Choices in California, Including Medicare Advantage Supplemental Benefits” (advance registration required). Presenters will include Stephanie Fajuri from the Center for Health Care Rights, an expert in Medicare choices for consumers, and Nils Franco from ATI Advisory, a lead analyst for the review of Medicare Advantage Plan supplemental benefits in California.​​  

The webinar will share helpful information for consumers, families, health care providers, and the public policy community. It will include a presentation and question and answer session on Medicare coverage choices for consumers during the Medicare Open Enrollment period from October 15 to December 7, as well as highlight a newly released DHCS chartbook on supplemental benefits in Medicare Advantage Plans in California for contract year 2023. The chartbook is part of a series of chartbooks available on the DHCS Office of Medicare Innovation and Integration webpage. For questions or comments, please email OMII@dhcs.ca.gov.​​ 

ກອງ​ປະ​ຊຸມ​ຄະ​ນະ​ກໍາ​ມະ​ທີ່​ປຶກ​ສາ​ຜູ້​ມີ​ສ່ວນ​ຮ່ວມ (SAC) ແລະ​ສຸ​ຂະ​ພາບ​ພຶດ​ຕິ​ກໍາ-SAC (BH-SAC)​​ 

On October 19, from 9:30 a.m. to 3:30 p.m., DHCS will host the next SAC and BH-SAC hybrid meeting (advance registration required). It will open as a joint meeting, with topics shared by SAC and BH-SAC. A BH-SAC-only meeting will be held after the joint meeting; there is no SAC-only meeting. Participants may attend in person at The California Endowment, located at 1414 K Street in downtown Sacramento, or virtually. For more information, please visit the SAC and BH-SAC webpages.​​ 

ໃນກໍລະນີທີ່ທ່ານພາດມັນ​​ 

ແຜນ Medicare Medi-Cal: ຂໍ້ມູນສໍາລັບພາກສ່ວນກ່ຽວຂ້ອງ​​ 

ໃນວັນທີ 22 ກັນຍາ, DHCS ໄດ້ລົງເອກະສານຂໍ້ເທັດຈິງກ່ຽວກັບແຜນ Medicare Medi-Cal ເປັນ ພາສາອັງກິດ, ພາສາສະເປນ, ພາສາມົ້ງ, ພາສາຫວຽດນາມ, ພາສາຈີນພື້ນເມືອງ/ພາສາກວາງຕຸ້ງ, ພາສາລັດເຊຍ ແລະ ພາສາຂະເໝນ/ພາສາກຳປູເຈຍ ໃນ ໜ້າເວັບແຜນ Medicare Medi-Cal.​​  

The 2024 Medicare open enrollment period is from October 15 to December 7, with plan coverage taking effect on January 1, 2024. Californians in 12 counties will be eligible to enroll in Medicare-Medi-Cal Plans, a type of Medicare Advantage plan in California only available to dual eligible members. Medicare Medi-Cal Plans provide more comprehensive care, and benefits in both programs are coordinated by one managed care plan. In 2024, Medicare Medi-Cal Plans will be available in the following counties: Fresno, Kings, Los Angeles, Madera, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Mateo, Santa Clara, and Tulare. Please contact DHCS with any questions or comments about Medicare Medi-Cal Plans at info@calduals.org.​​