Mahal na mga Stakeholder,

Ang Department of Health Care Services (DHCS) ay nagbibigay ng update na ito ng mga mahahalagang pag-unlad patungkol sa mga programa ng DHCS.​​ 

Paggawad ng Dental Contract​​ 

Noong Hulyo 1, 2022, naglabas DHCS ng Paunawa ng Layunin na Igawad ang kontrata ng Fiscal Intermediary-Dental Business Operations (FI-DBO), na magbibigay ng mga serbisyo upang suportahan ang benepisyo sa ngipin Medi-Cal Fee-for-Service sa California . Kasunod ng isang mapagkumpitensyang proseso ng pagkuha, ang matagumpay na bidder ay ang Gainwell Technologies LLC.

Sa susunod na taon, ang kasalukuyang vendor, ang Delta Dental ng California, ay ililipat ang mga operasyon patungo sa bagong vendor, ang Gainwell. Ang inaasahang petsa para sa Gainwell na akuin ang responsibilidad para sa mga operasyon sa negosyo ng ngipin ay Oktubre 1, 2023. Layunin ng DHCS na maging maayos ang transisyong ito para sa mga miyembro at tagapagbigay ng serbisyo ng Medi-Cal, nang walang pagbawas o pagkaantala ng mga serbisyo.​​ 

Proposition 56 Loan Repayment Program – CalHealthCares​​ 

DHCS announced its commitment to pay $64.9 million toward student loans for 222 physicians and 35 dentists under CalHealthCares to expand access to care for Medi-Cal patients under a fourth cohort of awardees. Of the 257 awardees, 62 percent are persons of color, and 79 percent speak a language other than English. The physicians represent 67 specialties and serve 33 counties. The dentists represent four specialties and serve 19 counties. The awardees have agreed to maintain a caseload of at least 30 percent Medi-Cal patients, with more than 57 percent of awardees committing to maintaining a caseload of 65 percent or higher. A fifth cohort is scheduled for 2023. For more information, visit the CalHealthCares website.​​ 

Update sa Benepisyo ng Enhanced Care Management (ECM) at Community Supports Benefit​​ 

Simula sa Hulyo 1, ang benepisyo ng ECM ay makukuha sa lahat ng mga county ng California sa mga karapat-dapat na miyembro ng Medi-Cal managed care plan (MCP) para sa mga sumusunod na populasyong pinagtutuunan ng pansin: mga indibidwal at pamilyang nakararanas ng kawalan ng tirahan, mataas na gumagamit, at mga nasa hustong gulang na may malubhang sakit sa isip (SMI) / substance use disorders (SUD). Ang mga county na bagong nagpapatupad ng ECM simula noong Hulyo 1 ay kinabibilangan ng Alpine, Amador, Butte, Calaveras, Colusa, Del Norte, El Dorado, Fresno, Glenn, Humboldt, Inyo, Lake, Lassen, Madera, Mariposa, Merced, Modoc, Mono, Nevada, Plumas, San Benito, San Luis Obispo, Santayo Barbarau, Sierrama Trinity, Tuolumne, Yolo, at Yuba.​​ 

Also, as of July 1, MCPs are implementing an additional 266 Community Supports, expanding service availability for these unique offerings to all 58 California counties. Significant service expansions include the housing-related Community Supports services, with MCPs introducing 35 new housing transition navigation services, 44 new housing deposits, and 36 new housing tenancy and sustaining services, as well as respite services (34 new offerings) and personal care and homemaker services (31 new offerings). With 518 Community Supports already available since initial program implementation on January 1, there are now 784 distinct Community Supports offerings available across all 58 counties in California. DHCS created a publicly available Community Supports map showing the number of the 14 pre-approved Community Supports going live in 2022 by county and implementation date. A Community Supports Election Chart is also available, detailing which are available under each MCP in each county and forecasting future expected service offerings.​​  

Benepisyo ng community health worker (CHW).​​ 

On July 1, the CHW benefit went live in both the Medi-Cal fee-for-service (FFS) and managed care delivery systems. The State Plan Amendment (SPA) for CHWs was submitted to the Centers for Medicare & Medicaid Services (CMS) on April 29, 2022, and is pending approval. DHCS published the final CHW policy on June 29 to assist providers with rolling out this new benefit. DHCS shared a draft of the Provider Manual pages for CHW services, as well as a new Provider Manual section for asthma preventive services, with stakeholders prior to finalizing them for publication. The Provider Manual pages are scheduled to be published on July 15. In addition, DHCS shared a draft All Plan Letter (APL) for CHW services with its managed care health plan partners on June 28 for comments prior to issuing the APL. Comments on the APL are due by July 12. More information about the Department’s development of the CHW benefit, including the pending SPA that was submitted to CMS, is available on CHW webpage.

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