DHCS Stakeholder News – December 23, 2022
Ibinibigay ng DHCS ang update na ito ng mga makabuluhang pagpapaunlad tungkol sa mga programa ng DHCS.
Nangungunang Balita
Ang Enhanced Care Management (ECM) at Community Supports Early Implementation Data
On December 22, DHCS released early implementation data for ECM and Community Supports, two major CalAIM programs that launched in 2022. ECM and Community Supports were designed to support high-need Medi-Cal members and address social drivers that impact their health, such as housing and nutrition. Data show the early reach of ECM and Community Supports in January through June, and highlight growing member enrollment in both programs, particularly among historically underserved populations.
As California continues to strengthen its capacity to deliver ECM and Community Supports services, more members will benefit from the state’s efforts to transform Medi-Cal, expand how and where members receive care, and build an equitable health care system for all. DHCS is committed to transparency and will continue to release implementation data to showcase the growing impact of ECM and Community Supports on the Medi-Cal delivery system and members statewide.
Bagong Medicare Provider Fact Sheet para sa Medi-Cal Managed Care Enrollment
DHCS published an updated fact sheet for Medicare providers to explain the provider billing process for dual eligible members enrolled in Medi-Cal managed care. This fact sheet describes the existing crossover billing process, which does not change under CalAIM. Medicare providers serving dual eligible patients do not need to enroll in a Medi-Cal managed care plan (MCP) to continue receiving reimbursement. More than 70 percent of dual eligible members statewide are already enrolled in Medi-Cal MCPs. Medicare benefits and providers do not change upon enrollment in a Medi-Cal MCP.
For patients in Original (fee-for-service (FFS)) Medicare, the Medicare Administrative Contractor processes the primary claim for Medicare payment, and then forwards the claim to the Medi-Cal MCP (or DHCS) for secondary Medi-Cal payment. For patients in Medicare Advantage (MA), the Medicare provider bills the MA plan for primary payment. The secondary payment process may depend upon whether the patient’s Medi-Cal MCP is the same or different than the MA plan. For more information, please visit the Statewide Medi-Cal Managed Care Enrollment for Dual Eligible Members webpage.
Public Charge Lahat ng County Welfare Directors Liham Na-publish
On December 22, DHCS released All County Welfare Directors Letter (ACWDL) 22-34 to inform counties of the final rule, entitled “Public Charge Ground of Inadmissibility” (2022 Final Rule), published by the U.S. Department of Homeland Security on September 9, 2022. Effective December 23, the 2022 Final Rule restores previous policies, including the exclusion of Medicaid when determining the use of public benefits, with the exception of long-term institutionalized care, and will apply to applications for visas, admission, and adjustment of status postmarked on or after the effective date. The ACWDL reminds counties that the 2022 Final Rule does not change whether individuals can apply for and receive public benefits. The public charge status of a Medi-Cal applicant or member has no impact on their eligibility for Medi-Cal benefits.
In September, an updated Public Charge Guide was posted (in 21 languages) on the California Health & Human Services Agency website to serve as a resource for individuals and families with questions about the current federal public charge policy. One can also visit the U.S. Citizenship & Immigration Services website for updated information and resources. For general questions about the final rule and public charge, a list of nonprofit organizations qualified to assist individuals is available on the California Department of Social Services website.
Mga Update sa Programa
Medi-Cal Rx
Ang mga sumusunod na notification para sa muling pagbabalik ng Medi-Cal Rx ay inilabas noong Disyembre 20:
- 30-araw na paunawa para sa Phase 2, Wave 1
- Na-update na listahan ng National Drug Code na inaprubahan ng Medi-Cal na nagpapakilala sa mga gamot na naapektuhan ng Phase 2, Wave 1 na paunang awtorisasyon na muling pagbabalik
- Phase 2 Frequently Asked Questions (FAQ)
- 90-araw na abiso para sa Phase 3.
Higit pang impormasyon tungkol sa plano sa muling pagbabalik ay makukuha sa webpage ng muling pagbabalik ng Medi-Cal Rx.
Pagpapalawak ng Kwalipikasyon ng Hearing Aid Coverage for Children Program (HACCP).
Beginning January 1, DHCS welcomes newly eligible young adults ages 18 through 20, who meet other program criteria and need coverage for their hearing aid(s) and related services, to apply for HACCP enrollment. Also, effective January 1, applicants under age 21 who meet program eligibility requirements may apply to enroll in HACCP even if they have partial other health coverage for hearing aids, subject to a coverage limit of $1,500 or less per year. Additional program information is available on the HACCP webpage. Families can apply to enroll for coverage through HACCP’s Online Application Portal.
Nai-publish ang Manwal ng Provider para sa Mga Serbisyo ng Doula
Inilathala ng DHCS ang bagong manu-manong provider para sa mga serbisyo ng doula noong Disyembre 16 bago ang benepisyong magiging live sa Enero 1, 2023. Inilalarawan ng manual ang patakaran para sa parehong FFS at mga sistema ng paghahatid ng pinamamahalaang pangangalaga na binuo sa pakikipagtulungan sa mga stakeholder pagkatapos ng higit sa isang taon ng pagtutulungan. Ang Pag-amyenda sa Plano ng Estado 22-0002 para sa mga serbisyo ng doula ay kasalukuyang nakabinbing pagsusuri sa Centers for Medicare & Medicaid Services. Ang benepisyong ito ay makakatulong sa DHCS na maabot ang mga mahihinang populasyon upang maiwasan ang mga komplikasyon sa perinatal at mapabuti ang mga resulta ng panganganak. Ang mga serbisyo ng Doula ay sumasaklaw sa edukasyon sa kalusugan, adbokasiya, at pisikal, emosyonal, at hindi medikal na suporta na ibinibigay sa buong panahon ng perinatal. Para sa karagdagang impormasyon, pakibisita ang Doula Services bilang isang Medi-Cal Benefit webpage.
Paparating na: Medi-Cal Telehealth Updates
In early January 2023, DHCS will refresh the telehealth webpage to include: an updated Telehealth Policy Paper reflecting final telehealth policies as adopted through the 2022-23 budget and related statutory changes; a Telehealth Research and Evaluation Plan; an updated FAQ page; updates to the Medi-Cal Telehealth Provider Manual; and a new page on patient consent, including model language for providers.
Current telehealth flexibilities adopted under the federal COVID-19 public health emergency (PHE) will remain as long as the PHE is in effect, and most flexibilities in place during the PHE will continue after the expiration of the PHE. During the PHE, providers should consult the Telehealth Provider Manual and additional PHE guidance to direct their delivery of services. After the PHE ends, providers should consult strictly only the Medi-Cal Telehealth Provider Manual. For questions, email Medi-Cal_Telehealth@dhcs.ca.gov.
Mga Application sa Clinic Workforce Stabilization Retention Payments (CWSRP).
On December 29, DHCS will begin accepting applications for CWSRP. All qualified clinics that successfully registered by the registration deadline, December 28, will receive a link to the application and can begin submitting the required information on behalf of eligible employees.
All applications for payment must be submitted no later than 5 p.m. on January 27, 2023. DHCS encourages early submissions so all applications can be validated before the due date. DHCS anticipates issuing payments to qualified clinics in February 2023. Clinics receiving funding must issue payments to qualified employees within 60 days of receipt of funds.
An application tutorial video, application guidance, and an Excel template for submitting employee information will be posted on the CWSRP webpage by December 29.
Mga Nanalo ng CalHOPE Courage Award
Sa Enero 4, 2023, kikilalanin ng DHCS ang mga nagwagi ng December CalHOPE Courage Award sa Sacramento Kings NBA game sa Golden 1 Center. Ang buwanang parangal ay nagpaparangal sa mga mag-aaral na atleta sa mga kolehiyo at unibersidad sa California para sa pagtagumpayan ng stress, pagkabalisa, at trauma sa pag-iisip na nauugnay sa mga personal na paghihirap at kahirapan.
Sumali sa Aming Koponan
DHCS is hiring! We are searching for a mission-driven, motivated leader to serve as Chief of the Human Resources Division. We are also hiring a Policy Advisor for Homelessness and Housing within the Health Care Delivery Systems program. The Policy Advisor leads and coordinates the planning, development, and implementation of new homelessness and housing-related Medi-Cal policies across DHCS programs.
Additionally, DHCS is hiring Californians to join our fiscal, human resources, legal, auditing, health policy, and information technology teams. For more information, please visit the CalCareers website.
DHCS is dedicated to preserving and improving the overall health and well-being of all Californians. DHCS’ mission is to provide eligible Californians with equitable access to affordable, integrated, high-quality, health care, and is currently transforming the Medi-Cal program to make sure it provides the equity-focused and person-centered care Californians need to live healthier, happier lives.
Kung sakaling Nalampasan Mo Ito
Ang DHCS ay Mamumuhunan ng Milyun-milyong Upang Matugunan ang Paggamit ng Opioid ng Kabataan
Noong Disyembre 20, naglabas ang DHCS ng isang news release na nag-aanunsyo ng pagkakaroon ng halos $3.4 milyon sa mga gawad na magagamit upang makatulong na mapabuti ang pangangalaga ng pasyente sa mga lugar ng karamdaman sa paggamit ng sangkap, karamdaman sa paggamit ng opioid, at pagkagumon. Maaaring mag-aplay ang mga organisasyon para sa mga gawad na hanggang $70,000.
Malapit nang Magsara ang Panahon ng Application para sa Ospital at Skilled Nursing Facility (SNF) COVID-19 Worker Retention Payments (WRP)
The application period for the Hospital and SNF COVID-19 WRP closes at 5 p.m. on December 30. DHCS is encouraging successfully registered Covered Entities (CEs), Covered Services Employers (CSEs), Physician Group Entities (PGEs), and Independent Physicians to submit applications prior to the deadline so all applications can be validated timely.
If you are a CE, CSE, PGE, or an Independent Physician and you have not yet registered, today, December 23, is the last day to register.
Para sa pagpaparehistro at paggabay sa aplikasyon , isang video tutorial ng application, at lahat ng iba pang sumusuportang impormasyon, pakibisita ang WRP webpage.