DHCS Stakeholder News – September 29, 2023
Nangungunang Balita
Napili si Tyler Sadwith para sa Medicaid Pathways Program
Inihayag ng Center for Health Care Strategies (CHCS) ngayong linggo na si Tyler Sadwith, Deputy Director para sa programang Behavioral Health ng DHCS, ay isa sa 20 umuusbong na lider ng ahensya ng Medicaid mula sa buong bansa na napili nang mapagkumpitensya upang lumahok sa ikatlong klase ng Medicaid Pathways Program. Si Tyler ang responsable sa pangunguna sa ambisyosong adyenda ng DHCS upang matiyak ang mataas na kalidad at naa-access na mga espesyal na serbisyo para sa kalusugang pangkaisipan at karamdaman sa paggamit ng droga sa Medi-Cal at iba pang mga pampublikong programa. Pinamumunuan niya ang pangkat ng Kalusugang Pangkaisipan ng Kagawaran sa pagbuo at pagpapatupad ng mga inisyatibo na idinisenyo upang palakasin ang pag-access, kalidad, pagkakapantay-pantay, at paghahatid ng serbisyo sa pangangalagang pangkalusugang pangkaisipan para sa 15.5 milyong miyembro ng Medi-Cal at mga taga-California na pinaglilingkuran sa pamamagitan ng mga pampublikong programa.
Mga Update sa Programa
2024 Gabay sa Patakaran sa Transisyon ng 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.
Pamilihan ng Teknikal na Tulong (TA) para sa Pagbibigay ng Access at Pagbabago ng Kalusugan (PATH) – Binagong Patakaran sa Pag-access ng Tatanggap ng TA
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 Round 3 Vendor Application
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).
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’ 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.
Mga Paparating na Mga Pagpupulong ng Stakeholder at Webinar
Consumer-Focused Stakeholder Workgroup (CFSW) Meeting
Sa Oktubre 6, mula 10:00 hanggang 11:30 ng umaga, ang DHCS ang magiging punong-abala ng pulong ng CFSW. Ang layunin ng CFSW ay bigyan ang mga stakeholder ng pagkakataong repasuhin at magbigay ng feedback sa iba't ibang materyales sa pagmemensahe para sa mga mamimili. Ang forum ay tututok sa mga aktibidad na may kaugnayan sa pagiging kwalipikado at pagpapatala at mag-aalok ng bukas na talakayan tungkol sa mga patakaran at tungkulin ng Medi-Cal. Ang mga kalahok sa CFSW ay mga tagapagtaguyod mula sa komunidad ng pangangalagang pangkalusugan, mga kinatawan ng mga asosasyon ng mga tagapagbigay ng serbisyo, at mga eksperto sa larangan ng pangangalagang pangkalusugan. Mangyaring mag-email ng anumang mga katanungan sa DHCSCFSW@dhcs.ca.gov. Ang lahat ng mga materyales para sa pulong ay ipo-post sa webpage ng DHCS CFSW nang hindi lalampas sa Oktubre 4.
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.
Makakakuha ng karagdagang detalye tungkol sa mga paparating na webinar sa webpage ng transisyon ng CalAIM ICF/DD Long-Term Care Carve-In. Mag-email ng mga tanong o komento sa LTCtransition@dhcs.ca.gov.
Mga Pagpipilian sa Saklaw ng Medicare sa California: 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.
Stakeholder Advisory Committee (SAC) at Behavioral Health- SAC (BH-SAC) Meeting
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.
Kung sakaling Nalampasan Mo Ito
Mga Plano ng Medicare Medi-Cal: Impormasyon para sa Mga Stakeholder
Noong Setyembre 22, nag-post ang DHCS ng mga fact sheet ng Medicare Medi-Cal Plan sa Ingles, Espanyol, Hmong, Vietnamese, Tradisyonal na Tsino/Cantonese, Ruso, at Khmer/Cambodian sa webpage ng Medicare Medi-Cal Plan.
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.