January 26, 2024 – Stakeholder News
Mga Update sa Programa
Updated Enhanced Care Management (ECM) and Community Supports Data
Sa Enero 29, magpo-post ang DHCS ng bagong ECM at Community Supports data mula sa Medi-Cal managed care plans (MCPs). Ang bagong ulat ay nagbibigay ng isang na-update na interactive na ulat na nagpapahusay sa ulat ng pagpapatupad ng 2022 sa pamamagitan ng pagbibigay ng detalyadong data sa antas ng estado, county, at MCP hanggang sa Quarter 2 2023. Ang susunod na quarterly update, na magsasama ng data ng pagpapatupad para sa Quarter 3 2023, ay binalak na ilabas sa pagtatapos ng Quarter 1 2024.
Medi-Cal Renewal Campaign Refresh
In early February, DHCS will refresh messaging for the Medi-Cal renewal campaign. New ads will prepare people for the return of annual Medi-Cal renewals. The ads will run on digital, television, radio, print, and out-of-home platforms. The content will be distributed through existing partnerships with Univision and Telemundo for Spanish-language television and a new partnership with CrossingsTV for Mandarin, Cantonese, Vietnamese, Punjabi, Korean, and Hmong programming. Select videos will also be updated to include voiceovers to increase accessibility and exposure to more audiences, such as the visually impaired and those who cannot read. Voiceover videos will be available in all threshold languages. New awareness and renewal outreach materials will be available on the Keep Your Community Covered resources hub for download and sharing in all 19 threshold languages.
Gumagamit din ang DHCS ng available na data para i-retarget ang mga komunidad na may mas mababang rate ng pag-renew, partikular na may mataas na rate ng mga disenrollment dahil sa hindi pagbibigay ng mga miyembro ng hiniling na papeles o impormasyon.
Gabay sa Iskedyul ng Bayarin sa Children and Youth Behavioral Health Initiative (CYBHI).
Noong Enero 25, inilabas ng DHCS ang draft na gabay sa iskedyul ng bayad sa CYBHI para sa pampublikong komento. Binabalangkas ng draft na dokumento ng gabay ang mga paunang patakaran at pamamaraan upang palawakin ang access sa mga serbisyong pangkalusugan ng pag-uugali na nauugnay sa paaralan sa pamamagitan ng iskedyul ng bayad na nauugnay sa paaralan na may maraming bayad sa buong estado (iskedyul ng bayad sa CYBHI) at kasama ang patnubay para sa Mga Lokal na Ahensyang Pang-edukasyon, mga itinalagang practitioner, Medi-Cal MCP, at iba pang mga tagaseguro.
DHCS is accepting feedback and public comment until February 7 at 5 p.m. Feedback and questions can be submitted to DHCS.SBS@dhcs.ca.gov. For more information, please visit the CYBHI webpage.
Comprehensive Perinatal Services Program (CPSP) Services Billing Expansion
Sa Pebrero 1, ipapatupad ng DHCS ang mga kinakailangang pagbabago sa system para payagan ang mga lisensyadong midwife na naka-enroll bilang mga provider ng CPSP sa California Department of Public Health (CDPH) na maningil para sa mga serbisyo ng CPSP na ibinibigay sa mga miyembro ng Medi-Cal fee-for-service (FFS). Kung mayroon kang mga tanong tungkol sa pagpapatala sa CPSP sa pamamagitan ng CDPH, mangyaring mag-email sa CPSPProviderEnrollment@cdph.ca.gov.
Sumali sa Aming Koponan
Ang DHCS ay kumukuha ng:
- Chief of Capitated Rates Development Division within Health Care Financing to serve as the principal policymaker for all rate-setting activities to ensure high-quality and cost-efficient health care through DHCS’ contracted Medi-Cal MCPs. (Final filing date is January 30)
DHCS is also hiring for our communications, human resources, auditing, health policy, information technology, and other teams. For more information, please visit the CalCareers website.
Mga Paparating na Mga Pagpupulong ng Stakeholder at Webinar
Pampublikong Pagdinig: Patuloy na Saklaw para sa Mga Bata na Pagbabago sa Demonstrasyon ng CalAIM
Sa Enero 29, mula 1 hanggang 2 p.m., ang DHCS ay magho-host ng isang pampublikong pagdinig (kinakailangan ang paunang pagpaparehistro) upang humingi ng mga komento ng stakeholder sa isang iminungkahing susog sa California Advancing and Innovating Medi-Cal (CalAIM) Seksyon 1115 na demonstrasyon na may kaugnayan sa patuloy na saklaw para sa mga bata.
DHCS is seeking approval from the Centers for Medicare & Medicaid Services (CMS) to include expenditure authority under Section 1115(a)(2) to receive federal matching funds to provide continuous coverage for children through the end of the month in which their 5th birthday falls, regardless of when they first enroll in Medi-Cal or the Children’s Health Insurance Program and any changes in circumstances that would otherwise cause a loss of eligibility. Implementation of this policy is contingent upon a state determination of available General Fund resources in 2024-2025 and subsequent fiscal years and CMS approval. Additional information is available on the DHCS CalAIM 1115 Demonstration and 1915(b) Waiver webpage.
Doula Stakeholder Implementation Workgroup Meeting
Sa Enero 31, mula 2 hanggang 4 ng hapon, magho-host ang DHCS ng Doula Stakeholder Implementation Workgroup meeting para suriin ang pagpapatupad ng Medi-Cal doula benefit, alinsunod sa Senate Bill 65 (Chapter 449, Statutes of 2021) at section 14132.24 ng Welfare and Institutions Code.
The meeting will be held via Zoom, with an in-person option at 1700 K Street, Room 1014, Sacramento, CA 95811. The meeting is open to the public. The link to attend the meeting virtually and the agenda are posted on the Doula Services as a Medi-Cal Benefit webpage. The workgroup will discuss how to ensure doula services are available to Medi-Cal members and make recommendations on outreach efforts. Please email DoulaBenefit@dhcs.ca.gov with any questions.
Virtual Meeting ng Consumer-Focused Stakeholder Workgroup (CFSW).
On February 2, beginning at 10 a.m., DHCS will hold the next CFSW meeting. The agenda, meeting materials, and instructions on how to join the meeting will be posted on the DHCS CFSW webpage by noon on January 31.
Webinar ng ECM para sa Birth Equity Populations
Sa Pebrero 2, mula 1:30 hanggang 3 p.m., ang DHCS ay magho-host ng isang webinar sa Paglulunsad ng ECM para sa Birth Equity Populations (kinakailangan ang paunang pagpaparehistro) upang suriin ang pangitain ng ECM para sa populasyon ng equity ng kapanganakan (POF), pati na rin ang mga unang araw ng pagpapatupad. Ang DHCS, sa pakikipagtulungan sa Medi-Cal MCPs at mga provider sa buong estado, ay naglunsad ng ECM para sa birth equity POF noong Enero 1. Ang webinar na ito ay magbibigay ng isang pangkalahatang-ideya ng disenyo at patnubay sa pagpapatakbo para sa kapanganakan equity POF; magbigay ng mga pananaw sa provider kung paano sila naghanda para sa paglulunsad ng ECM para sa POF ng equity ng kapanganakan at nababagay na mga diskarte sa pagbibigay ng ECM; at mag-alok ng patnubay sa mga MCP, county, at provider sa pagkontrata at paghahanda upang maihatid ang benepisyo ng ECM upang matugunan ang mga kilalang pagkakaiba sa kalusugan at mga kinalabasan ng kapanganakan sa mga pangkat ng lahi at etniko na may mataas na maternal morbidity at mortality rate.
Ang webinar ay bukas sa lahat, ngunit magiging espesyal na interes sa mga MCP at provider na nagtatrabaho sa mga populasyon ng birth equity, kabilang ang mga county at mga organisasyong nakabatay sa komunidad. Ang mga provider na interesadong matuto pa tungkol sa ECM para sa birth equity POF o tungkol sa mga nagre-refer na miyembro ay maaari ding dumalo. Inaanyayahan ang mga kalahok na magsumite ng mga tanong bago ang Enero 29 sa CalAIMECMILOS@dhcs.ca.gov. Ang mga dadalo ay makakapagtanong sa panahon ng webinar.
Hearing Aid Coverage for Children Programa (HACCP) Webinar para sa mga Medical Provider at Hearing Professionals
On February 13, from 12 to 1 p.m., DHCS will host a HACCP webinar (advance registration required) to share information with providers to help pediatric patients and their families maximize HACCP benefits. The training session will outline program requirements for families to apply for coverage. It will also outline the claims submission process for audiologists, otolaryngologists, physicians, and their office staff. For more information, please visit www.dhcs.ca.gov/haccp.
Kung sakaling Nalampasan Mo Ito
Medi-Cal Targeted Rate Increases (TRI)
Pursuant to Assembly Bill (AB) 118 (Chapter 42, Statutes of 2023), DHCS published, as part of the proposed 2024–25 Governor’s Budget, a plan for targeted increases to Medi-Cal payments or other investments, effective in 2025, across primary care, maternal care, behavioral health care, specialty care, women’s health services, public hospital services, community and hospital outpatient services, emergency services, and other domains. The proposed investments will be supported with funding from the Managed Care Organization (MCO) Tax, authorized by AB 119 (Chapter 13 , Statutes of 2023), and are designed to advance access, quality, and equity for Medi-Cal members and promote provider participation in the Medi-Cal program. These proposed investments are subject to obtaining all necessary legislative and federal approvals, as applicable. For more information, please visit the Medi-Cal Targeted Provider Rate Increases and Investments webpage and view the Medi-Cal TRI policy paper and MCO Tax-funded investments.
Tuloy-tuloy na Pag-unwinding ng Data sa 90-Araw na Pag-refresh
Noong Disyembre 29, nagsumite ang DHCS sa CMS ng ipinag-uutos na update sa federal unwinding data para sa Hunyo hanggang Agosto 2023. Ang mga indibidwal na itinigil sa Medi-Cal para sa mga kadahilanang pamamaraan ay may 90 araw upang magsumite ng kinakailangang impormasyon sa mga county upang makumpleto ang kanilang pag-renew. Dahil sa kinakailangang timing para magsumite ng unwinding data, hindi kasama sa mga naunang pagsusumite ang mga indibidwal na naibalik ang kanilang Medi-Cal sa loob ng 90-araw na panahon ng muling pagsasaalang-alang. Kasama sa update na ito ang pag-refresh ng naunang isinumiteng data, kabilang ang mga resulta para sa mga indibidwal sa 90-araw na panahon ng muling pagsasaalang-alang.
The updated data is accessible on the Medi-Cal Enrollment and Renewal Data webpage under the “Medi-Cal Continuous Coverage Unwinding Dashboards” section. Additionally, the California Health & Human Services Agency posted on its Medium page a piece by DHCS Director Michelle Baass about the 90-day data refresh.
Enero 2024 Medi-Cal MCP Transition
On January 1, DHCS achieved a significant milestone in its transformation of Medi-Cal with the launch of the new managed care contract and the MCP transition, under which approximately 1.2 million members gained new health plan options and/or transitioned to new MCPs (note: changing MCPs does not affect Medi-Cal member coverage or benefits). To facilitate a smooth transition between MCPs for members, DHCS created Continuity of Care protections to minimize disruptions to members’ care.
DHCS developed several resources to support members, providers, and other stakeholders with the transition, including the MCP Transition Member webpage with a county “lookup” tool, links to the member notices sent by Medi-Cal about MCP changes, member frequently asked questions in all threshold languages, and a Contact Us page for members to learn more about health plan changes. There are also transition resources for providers, MCPs, and stakeholders. More information about the transition is available in the 2024 MCP Transition Policy Guide and Medi-Cal Eligibility Division Information Letter Number I 23-54.
The MCP Transition Member webpage includes resources and information to support members’ transition. Members unable to resolve issues or questions after working with their MCP may contact DHCS’ Office of the Ombudsman at toll-free (888) 452-8609 or by emailing MMCDOmbudsmanOffice@dhcs.ca.gov.