Nangungunang Balita​​ 

Bagong Kahilingan ng Pederal ng DHCS sa Flexibility ng Asset Sa Tuloy-tuloy na Pag-alis ng Saklaw​​ 

On March 10, DHCS submitted a waiver flexibility request to the Centers for Medicare & Medicaid Services (CMS) to support the unwinding of the continuous coverage requirement. The Section 1902(e)(14)(A) waiver flexibility seeks to make it easier for Non-Modified Adjusted Gross Income (MAGI), for example seniors and persons with disabilities, to renew their Medi-Cal coverage—and remain covered until California eliminates the asset limit on January 1, 2024. It will allow counties to use existing case file information to grant eligibility during renewals, and disregard any increases in assets since the last Medi-Cal determination. Also, for individuals who were not initially subject to an asset test at the time of their Medi-Cal application, but have now transitioned into a program requiring one, the waiver flexibility would allow California to renew based on their last known eligibility determination on file. DHCS is requesting this authority to be effective retroactive to March 1, 2023, and remain in effect through December 31, 2023.​​ 

The requested waiver flexibility only applies to Medi-Cal renewals and not to new applications. New Medi-Cal applications, specifically for Non-MAGI programs, are still subject to the asset test until it is eliminated. The asset test for new Medi-Cal non-MAGI applications was raised to $130,000 per individual and $65,000 per additional person on July 1, 2022. It is important to note that non-MAGI Medi-Cal members will still need to meet all other Medi-Cal eligibility criteria, including income, to remain Medi-Cal eligible at redetermination.​​ 

Kapag naaprubahan ng CMS, maglalabas ang DHCS ng agarang patnubay sa mga county sa pamamagitan ng isang Liham ng Impormasyon sa Dibisyon ng Pagiging Karapat-dapat sa Medi-Cal.​​  

Mga Update sa Programa​​ 

2024 Pagpapalawak ng Mga Plano ng Medi-Medi sa Mga Karagdagang Counties​​ 

Starting January 1, 2024, DHCS will expand the availability of Medi-Medi Plans for dual eligible Medicare and Medi-Cal members to five additional central valley counties: Fresno, Kings, Madera, Sacramento, and Tulare. Medi-Medi Plans for dual eligible Medicare and Medi-Cal members are currently available in the seven former Coordinated Care Initiative (CCI) counties: Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Mateo, and Santa Clara.​​ 

Medi-Medi Plans is the California-specific program name for Medicare Advantage Exclusively Aligned Enrollment Dual Eligible Special Needs Plans (D-SNPs). Under Medi-Medi Plans, dual eligible members can voluntarily enroll in a D-SNP for Medicare benefits and in a Medi-Cal managed care plan (MCP) for Medi-Cal benefits, which are both operated by the same parent organization for better care coordination and integration.​​ 

Ang DHCS ay nakikipagpulong sa mga lokal na stakeholder sa limang expansion county upang magbigay ng higit pang impormasyon tungkol sa Medi-Medi Plans, at isasama ang paksang ito sa mga susunod na pagpupulong ng Managed Long-Term Services & Supports & Duals Integration Workgroup. Higit pang impormasyon tungkol sa Medi-Medi Plans ay makukuha sa Medicare Medi-Cal Plans webpage. Mangyaring mag-email sa OMII@dhcs.ca.gov para sa anumang mga katanungan.​​ 

Proyekto ng Health Enrollment Navigators​​ 

Ang Navigators Project kamakailan ay gumawa ng mga pag-update sa webpage upang magbigay ng mas naka-target na impormasyon para sa mga komunikasyon ng tagapagtaguyod at stakeholder, mga kasosyo sa proyekto, at pangkalahatang mga anunsyo / iba pang mga komunikasyon. Kasama rin sa webpage ng mga kasosyo sa proyekto ang partikular na impormasyon na may kaugnayan sa Senate Bill (SB) 154 na mga parangal sa pagpopondo, isang listahan ng mga lokal na organisasyong nakabatay sa komunidad at mga subcontracted entity ayon sa county, at ang Buod ng Kasosyo sa Proyekto, na nagdedetalye ng mga pagsisikap sa mataas na antas ng trabaho, tulad ng mga layunin sa pagpapatala at pagpapanatili, mga halaga ng pagpopondo, mga subcontractor, at mga target na populasyon na pinaglilingkuran.​​ 

Pederal na Pag-apruba ng Mpox Vaccine Administration para sa mga Klinika​​ 

CMS recently approved a State Plan Amendment (SPA) to reimburse vaccine-only encounters at the fee-for-service (FFS) rate at certain clinics, retroactive to August 17, 2022. SPA 22-0062 pertains to Federally Qualified Health Centers (FQHC), Rural Health Clinics (RHCs), Indian Health Services Memorandum of Agreement (IHS-MOA), and Tribal FQHC clinic providers.​​ 

Effective March 10, 2023, FQHC, RHC, IHS-MOA, and Tribal FQHCs may submit claims for members enrolled in Medi-Cal managed care for Mpox vaccine-only encounters. Likewise, claims for FFS members may be submitted by FQHC, RHC, IHS-MOA, and Tribal FQHC providers using the instructions published in the December 13, 2022, article “Mpox Vaccines Reimbursement at the Medicare Rate“.​​ 

This reimbursement policy is effective for dates of service on or after August 17, 2022, through January 31, 2023, the end of the Mpox state public health emergency (PHE). At the conclusion of the PHE, the reimbursement rates for Mpox vaccine administration returned to the Medi-Cal FFS rates in effect at that time. Providers are reminded that each administration of the Mpox vaccine falls under a qualifying office visit or vaccine-only encounter, not both.​​ 

FQHC, RHC, IHS-MOA, and Tribal FQHC providers will receive a 120-day timeliness override to submit the Mpox vaccine-only encounters.​​ 

Traditional Indian Health (TIH) Request for Application (RFA) Release​​ 

During the week of March 20, DHCS anticipates the release of a RFA to fund three TIH education programs that will assist Indian clinics in providing services to American Indians in a culturally appropriate manner and to provide a forum for the Indian community to address TIH education. A total of $300,000 is available to fund regional TIH programs for two fiscal years. This funding opportunity supports the provision of traditional Indian health care. Funds for this project are part of the $11,576,000 allocated in the fiscal year 2022-23 budget for the restoration of Indian Health Program grant programs.​​ 

It is anticipated that $100,000 per region will be made available to support each regional program for two fiscal years. The maximum funding is $50,000 per region per fiscal year. The grant term is projected to start in May 2023 and continue through June 30, 2024.​​ 

For questions about the RFA, please email TribalAffairs@dhcs.ca.gov.​​ 

Sumali sa Aming Koponan​​  

Ang DHCS ay kumukuha para sa aming mga pangkat ng piskal, human resources, legal, pag-audit, patakaran sa kalusugan, at teknolohiya ng impormasyon. Para sa karagdagang impormasyon, mangyaring bisitahin ang website ng CalCareers.​​   

DHCS is dedicated to preserving and improving the overall health and well-being of all Californians. DHCS’ mission is to provide the most vulnerable residents with equitable access to affordable, integrated, and high-quality health care, and is currently transforming the Medi-Cal program to make sure it provides the care Californians need to live healthier, happier lives.​​  

Mga Paparating na Mga Pagpupulong ng Stakeholder at Webinar​​ 

California’s Reproductive Health Access Section 1115 Demonstration: Tribal and Designee of Indian Health Programs Webinar​​ 

On March 20, from 9 to 10 a.m., DHCS will host a Medi-Cal Tribal and Designee of Indian Health Programs webinar (advance registration required) to provide information and receive feedback on California’s Reproductive Health Access Demonstration (CalRHAD) 1115 request in advance of DHCS’ submission to CMS. Tribal partners have been invited to participate in the webinar via email.​​ 

California’s Reproductive Health Access Section 1115 Demonstration: First Public Hearing​​ 

On March 29, from 10 to 11 a.m., DHCS will host the first (advance registration required) of two public hearings to solicit stakeholder comments on a proposed CalRHAD Medicaid Section 1115 demonstration. DHCS is seeking approval from CMS to provide competitive grants to reproductive health providers to enhance capacity and access to sexual and reproductive health services, promote the sustainability of California’s reproductive health provider safety net, and benefit individuals enrolled in Medi-Cal and other individuals who currently face barriers to such access.​​ 

Screening at Transition of Care Tools Informational Webinar​​ 

On March 29, from 3 to 4 p.m., DHCS will hold a Screening and Transition of Care Tools webinar (advance registration required) to discuss the Adult and Youth Screening and Transition of Care Tools for Medi-Cal Mental Health Services, which went live on January 1, 2023, as part of California Advancing and Innovating Medi-Cal (CalAIM). This initiative is focused on implementing statewide screening and transition of care tools for both adults and individuals under 21 years old for use by Medi-Cal MCPs and county mental health plans. The webinar will include an overview of the purpose of the initiative, a discussion on notable requirements and case examples, and responses to frequently asked questions. For more information, please visit the Screening and Transition of Care Tools webpage.​​ 

Children and Youth Behavioral Health Initiative (CYBHI) Buwanang Pampublikong Webinar: Marso 2023​​ 

On March 29, from 3 to 4 p.m., DHCS will virtually host a webinar (advance registration required) to keep stakeholders apprised of DHCS’ progress in implementing various workstreams for CYBHI. Key attendees include, but are not limited to, youth, parents, family members, behavioral health providers, Medi-Cal MCPs, county behavioral health departments, and commercial health plans, as well as educational and other cross-sector partners.​​ 

Doula Stakeholder Workgroup Meeting​​ 

Sa Marso 30, mula 12 hanggang 2 pm, magho-host ang DHCS ng unang pampublikong virtual na stakeholder workgroup meeting tungkol sa mga serbisyo ng doula. Inaatasan ng SB 65 ang DHCS na magpulong ng isang workgroup upang suriin ang pagpapatupad ng benepisyo ng doula sa Medi-Cal. Tatalakayin ng workgroup ang mga paraan upang matiyak na ang mga serbisyo ng doula ay magagamit sa mga miyembro ng Medi-Cal, isaalang-alang ang mga paraan upang mabawasan ang mga hadlang at pagkaantala sa mga pagbabayad sa mga doula, at magrekomenda ng mga pagsisikap sa outreach upang malaman ng mga miyembro ang mga available na serbisyo ng doula. Ang link sa pagpaparehistro ng pulong ay magiging available sa doula webpage bago ang Marso 24.​​ 

CYBHI RFA Technical Assistance Webinar​​ 

On March 30, from 1 to 2 p.m., DHCS will virtually host a public CYBHI webinar (advance registration required) on behalf of the Evidence-Based Practices (EBP) and Community-Defined Evidence Practices (CDEP) grants program. This webinar will focus on the “Round Two: Trauma-Informed Programs and Practices” RFA. DHCS will provide technical assistance by sharing responses to frequently asked questions received based on themes. During the webinars, DHCS will not address any live questions. Please email questions related to the Round Two RFA to CYBHI@dhcs.ca.gov. DHCS will post the FAQs to the CYBHI EBP/CDEP grants webpage by March 17.​​ 

Kung sakaling Nalampasan Mo Ito​​ 

California Awards $21.6 Million para Tugunan ang Opioid Crisis​​ 

On March 13, DHCS awarded $12 million to 44 programs through the California Youth Opioid Response project, and $9.6 million to 28 entities through the Low-Barrier Opioid Treatment at Syringe Services Programs project. This is the latest investment in a running total of more than half a billion dollars to help prevent opioid overuse and addiction, address opioid use disorders safely and effectively, and reduce overdose deaths.​​ 

Nagbibigay ang DHCS ng Update sa Behavioral Health Virtual Services Platform para sa mga Bata at Kabataan​​ 

On March 15, DHCS confirmed it will launch the Behavioral Health Virtual Services Platform, a new technology-enabled services solution for all children, youth, and families in California, in January 2024. The platform is part of Governor Newsom’s Master Plan for Kids’ Mental Health and CYBHI. For more information, please visit the CYBHI webpage.​​ 

Demonstrasyon ng Seksyon 1115 ng Access sa Reproductive Health ng California​​ 

On March 16, DHCS launched 30-day public and Tribal public comment periods to solicit feedback on a proposed CalRHAD Medicaid Section 1115 demonstration. DHCS is seeking approval from CMS to provide competitive grants to reproductive health providers to enhance capacity and access to sexual and reproductive health services, promote the sustainability of California’s reproductive health provider safety net, and benefit individuals enrolled in Medi-Cal and other individuals who currently face barriers to such access.​​ 

Additional information about the CalRHAD application is available on the CalRHAD webpage.​​