Bumalik sa Iminungkahing Mga Pagbabago sa Plano ng Estado ayon sa Taon

These proposed State Plan Amendments (SPAs) would change statewide methods and standards for Medicaid payment rates. All of these SPAs require a Public Notice prior to submission to the Centers for Medicare & Medicaid Services (CMS). All 2024 Public Notice announcements will be published on this webpage when they are available. Once these SPAs are submitted to or approved by CMS they are also posted in the pending or approved SPAs pages. For any questions or concerns, please contact PublicInput@dhcs.ca.gov.

• 24-0002 Proposes to extend the Public Provider Ground Emergency Medical Transport Intergovernmental Transfer Program in calendar year 2024. (Released December 29, 2023)
• 24-0003 at SPA Pages Iminumungkahi na isama ang Psychiatric Residential Treatment Facilities (PRTFs) bilang isang setting kung saan maaaring ibigay ang inpatient psychiatric services sa mga benepisyaryo na wala pang 22 taong gulang. Bilang karagdagan, ang SPA na ito ay magsasama ng isang pamamaraan ng pagbabayad para sa inpatient psychiatric na serbisyo na ibinibigay sa mga PRTF. (Inilabas noong Disyembre 20, 2023)
• 24-0004 Nagmumungkahi na i-renew at baguhin ang metodolohiya ng reimbursement para sa Freestanding Skilled Nursing/Subacute Facilities Level-B at ipatupad ang Workforce Standards Program. (Inilabas noong Disyembre 28, 2023)
  • Paalala: Ang takdang araw ng pagpapadala ng mga komento ay Lunes, Enero 29, 2024.
• 24-0005 at SPA Pages Nagmumungkahi na magdagdag ng mga grupong tahanan para sa mga batang may espesyal na pangangailangan sa pangangalagang pangkalusugan bilang isang bagong tagapagkaloob ng mga serbisyo sa pagsasaayos ng pamumuhay sa komunidad at magdagdag ng nakadirekta sa kalahok bilang isang paraan ng paghahatid ng serbisyo para sa mga self-directed na serbisyo ng suporta. (Inilabas noong Pebrero 6, 2024)
• 24-0006 at Mga Pahina ng SPA Nagmumungkahi na ipatupad ang susunod na pag-ikot ng mga pagsasaayos ng reporma sa rate, epektibo sa Hulyo 1, 2024, gaya ng kasalukuyang kinakailangan sa Welfare and Institutions Code section 4519.10. Ang 2024-25 na Badyet ng Gobernador ay nagmumungkahi na ibalik ang buong pagpapatupad ng reporma sa rate, kasama ang susunod na yugto ng mga pagsasaayos, sa orihinal na petsa ng Hulyo 1, 2025 mula sa pinabilis na petsa ng Hulyo 1, 2024. Ang California Department of Developmental Services (DDS) ay patuloy na naghahanda nang administratibo para sa buong pagpapatupad ng reporma sa rate, na napapailalim sa panghuling 2024-25 na kasunduan sa badyet. (Inilabas noong Pebrero 6, 2024)
• 24-0007 Proposes to update the Alternative Benefit Plan (ABP) to add PRTFs as settings where inpatient psychiatric services can be provided to Medi-Cal members under 21 years of age. This SPA also seeks to update the ABP to allow Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) to bill for encounters by Licensed Professional Clinical Counselors (LPCCs) services, and Associate Professional Clinical Counselors (APCCs). (Released March 14, 2024)
• 24-0009 Proposes the Medi-Cal program to enter into value-based supplemental drug rebate agreements with manufacturers and to seek approval for an associated Value-Based Supplemental Drug Rebate Agreement template. (Released February 21, 2024)
• 24-0011 Iminumungkahi ang estado na pumasok sa isang Medicare Part A Buy-In na kasunduan sa CMS. (Inilabas noong Setyembre 25, 2024)
• 24-0013 at Mga Pahina ng SPA Nagmumungkahi na palawigin at i-update ang mga halaga ng pagbabayad para sa karagdagang reimbursement para sa Programa ng Kwalipikadong Pribadong Ospital hanggang Hunyo 30, 2025. (Inilabas noong Mayo 30, 2024)  
• 24-0014 at SPA Pages ay nagmumungkahi na palawigin ang karagdagang reimbursement para sa Qualified Non-Designated Public Hospitals Program hanggang Hunyo 30, 2025. (Inilabas noong Mayo 30, 2024)
• 24-0015 Proposes to add APCC services as covered Medi-Cal services for FQPHCs, RHCs, and Tribal FQHCs. (Released March 12, 2024)
• 24-0016 Proposes to add Community Health Workers as a covered dental benefit to the Medi-Cal program. (Released March 6, 2024) 
• 24-0017 and SPA Pages Proposes to update the Medi-Cal reimbursement methodology for Diagnosis Related Group Payments for State Fiscal Year 2024-25. (Released May 30, 2024)
  • 24-0017 Addendum Proposes to add additional long-acting reversible contraception codes to the Separately Payable Services, Devices, and Supplies list. (Released June 27, 2024)
• 24-0019 Proposes to decrease the payment cap for supplemental payments for Martin Luther King Jr. – Los Angeles Healthcare Corporation. (Released May 30, 2024)
• 24-0025 Proposes to to renew the Ground Emergency Medical Transportation Quality Assurance Fee program and the reimbursement add-on provided for Medi-Cal ground emergency medical transports, effective for dates of service July 1, 2024 through June 30, 2025. (Released April 5, 2024)
• 24-0026 – Pakitingnan ang Addendum ng Pampublikong Paunawa ng SPA 24-0029 sa ibaba para sa karagdagang impormasyon.
• 24-0027 Proposes to update Intergovernmental (IGT) funded payments for the Supplemental Reimbursement for Qualified Private Hospitals for State Fiscal Year 2023-24. (Released March 30, 2024)
  • 24-0027 Addendum Nagmumungkahi ng mga binagong pagtatantya sa pananalapi. (Inilabas noong Abril 25, 2024)
• 24-0028 Nagmumungkahi ng susog sa Medi-Cal Home and Community Based Services 1915(i) Plano ng Estado para sa mga may kapansanan sa pag-unlad. 
• 24-0029 Proposes to revise hospital program eligibility criteria and make associated technical edits to various supplemental reimbursement methodologies. (Released March 29, 2024)
  • Ang 24-0029 Addendum ay nagbibigay ng update para sa iminungkahing SPA 24-0026. (Inilabas noong Hunyo 26, 2024)
  • 24-0029 Addendum Nagmumungkahi na isama ang mga karagdagang pasilidad. (Inilabas noong Setyembre 20, 2024)
  • 24-0029 Addendum Provides clarifications on Disproportionate Share Hospital eligibility for cost-based hospitals. (Released September 25, 2024)
• 24-0031 Proposes to make clarifying and technical edits to Behavioral Treatment Services. (Released December 30, 2024)
• 24-0033 at SPA Pages Nagmumungkahi na magdagdag ng alternatibong pamamaraan ng pagbabayad para sa capitated reimbursement ng mga kalahok na kwalipikadong pederal na health center. (Inilabas noong Hunyo 3, 2024)
• 24-0034 Proposes to increase reimbursement rates for the Prenatal Screening and Newborn Screening Programs. (Released June 21, 2024)
• 24-0035 Proposes to update the eligibility requirements for the Health Insurance Premium Payment (HIPP) program. As currently worded, if a HIPP member does not have an existing policy, has not applied for Medicare benefits, or has the option to enroll in a managed care plan, they are ineligible for HIPP. DHCS seeks to remove these requirements. (Released November 15, 2024)
• 24-0038 Nagmumungkahi na palawakin ang listahan ng mga tagapagbigay ng serbisyo na maaaring mangasiwa sa mga Community Health Worker (CHW). Nagpanukala rin ang DHCS ng mga teknikal na pagbabago sa ABP upang maisama ang mga kamakailang pagbabago sa mga espesyal na serbisyo sa kalusugang pangkaisipan at upang linawin ang saklaw ng paggamot sa kalusugang pangkaisipan. (Inilabas noong Setyembre 12, 2024)
• 24-0039 Proposes to eliminate the Alternative Payment Methodology for COVID-19 vaccine-only visits to Federally Qualified Health Centers, Rural Health Clinics, and Tribal Health Programs.
• Iminumungkahi ng 24-0041 at SPA Pages na i-update ang mga uri ng tagapagbigay ng serbisyo para sa clinical trainee provider ng Medi-Cal Rehabilitative Mental Health Services, Targeted Case Management, Substance Use Disorder Treatment Services, Expanded Substance Use Disorder Treatment Services, at Medication-Assisted Treatment. (Inilabas noong Hunyo 3, 2024)
  • Note: In Supplement 2 to Attachment 3.1-B p. 11, the definition for “Clinical Trainee” includes individuals who are enrolled in a post-secondary educational degree program to become a “Registered Pharmacists”. The term ‘Registered” was mistakenly included within this definition and should instead state “Pharmacist.”
• 24-0042 Proposes to expand the continuum of Community-Based Services and Evidence-Based Practices available through Medi-Cal Specialty Behavioral Health Delivery Systems. (Released September 13, 2024)
• 24-0044 and SPA Page Proposes to add rates to the fee schedule for Withdrawal Management (WM) Levels 1 and 2 for providers in all DMC-ODS Counties. (Released October 3, 2024)
• Iminumungkahi ng 24-0045 at SPA Pages na palawigin ang isang programang pandagdag sa pagbabayad na may limitadong oras para sa mga kwalipikadong 340B community clinic na hindi para sa ospital. (Inilabas noong Hunyo 27, 2024)
• 24-0047 Nagmumungkahi na i-update ang mga rate ng reimbursement para sa Community-Based Mobile Crisis Intervention Encounters. (Inilabas noong Hunyo 28, 2024)
• 24-0051 Proposes to add Supported Employment as a covered service under the ABP and to add additional eligibility groups to the ABP. (Released November 13, 2024)
• 24-0052 Nagmumungkahi na magdagdag ng Mga Pinahusay na Serbisyo ng CHW bilang Rehabilitative Mental Health Service, Substance Use Disorder (SUD) Service, at Expanded SUD Service. (Inilabas noong Setyembre 13, 2024)
• 24-0053 Proposes to add specified hospitals to list of government-operated hospitals receiving cost-based reimbursement for inpatient hospital services. (Released September 27, 2024)
• 24-0054 Nagmumungkahi na itatag na, para sa mga hindi inilaang kasunduan, hatol, at/o gawad, ang medikal na alokasyon ay hindi dapat hihigit sa 50 porsyento ng kasunduan, hatol, at/o gawad pagkatapos ibawas ang mga bayarin sa abogado at mga gastos sa litigasyon. (Inilabas noong Disyembre 10, 2024)