Marso 24, 2025
Nangungunang Balita
Nagsumite ang California ng Aplikasyon para Palawakin ang Paggamot sa Sickle Cell Disease
On March 11, DHCS applied to CMS to participate in the groundbreaking Cell and Gene Therapy (CGT) Access Model. If accepted, DHCS will implement this multi-year initiative to expand Medi-Cal members’ access to innovative and potentially life-changing therapies for sickle cell disease (SCD), a severe genetic blood disorder that disproportionately impacts people of African descent. Gene therapy represents a groundbreaking approach to SCD. However, these therapies come with extraordinary costs, making access difficult for patients and Medicaid programs, including Medi-Cal. The CGT Access Model addresses this challenge by using a negotiated rebate system that ties payments for these treatments to patient outcomes. If the therapy does not meet expected health improvements, drug manufacturers will provide rebates to Medicaid programs, helping ensure financial sustainability while expanding access to care. If California is approved, eligible Medi-Cal members would gain access to gene therapy treatment, fertility preservation services, case management, travel assistance, and behavioral health support. CMS anticipates testing the model over an 11-year performance period. If approved, California will begin participating in this model on July 1, 2025.
Pagpapatupad ng Benepisyo sa Mga Tradisyunal na Kasanayan sa Pangangalagang Pangkalusugan
On March 21, DHCS published Behavioral Health Information Notice (BHIN) 25-007 – Traditional Health Care Practices Benefit Implementation. This policy, the result of years of dedicated effort and advocacy from California Tribal leaders and partners, provides guidance on the implementation of the traditional health care practices benefit in the Drug Med-Cal Organized Delivery System (DMC-ODS). The federal Centers for Medicare & Medicaid Services (CMS) approved DHCS to cover traditional health care practices provided by Indian Health Care Providers (IHCP) for Medi-Cal members in DMC-ODS counties through December 31, 2026, unless extended or amended. Traditional health care practices encompass two new service types: Traditional Healer and Natural Helper services. DMC-ODS counties will cover Traditional Healer and Natural Helper services provided by IHCPs to Medi-Cal members who meet DMC-ODS access criteria. For questions about traditional health care practices or this BHIN, please email traditionalhealing@dhcs.ca.gov.
Additionally, on April 22, DHCS will present an overview of BHIN 25-007 at the Tribes and Indian Health Program Representatives meeting (advance registration required). The presentation is open to the public and will review policy guidance to support IHCPs and DMC-ODS counties in implementing this new benefit. Attendees are encouraged to submit questions in advance to traditionalhealing@dhcs.ca.gov with the subject line “Traditional Health Care Practices Implementation.”
Mga Update sa Programa
Magagamit na Ngayon: Mga Materyales sa Webinar sa Closed-Loop Referral Implementation Guidance
Effective July 1, 2025, Medi-Cal managed care plans will be required to implement Closed-Loop Referral (CLR) requirements for Enhanced Care Management (ECM) and Community Supports. CLR requirements aim to increase the number of Medi-Cal members successfully connected to these benefits and services. By improving information collection processes, managed care plans will be able to better support individual referrals and address system-level gaps in referral practices and service availability that impact members. DHCS released materials from the February 13 webinar (posted under Informational Webinars) to share more details about these requirements. In the webinar, DHCS provided:
- The Department’s goal and motivation for releasing new CLR requirements.
- Paano mapapabuti ng mga kinakailangan ng CLR ang proseso ng referral ng miyembro sa pamamagitan ng pag-streamline ng mga pagsusumikap sa pagsubaybay, pagsuporta, at pagsubaybay sa referral.
- Isang halimbawang senaryo ng use-case kung paano matutulungan ng mga kinakailangan ng CLR ang isang miyembro sa pagtanggap ng Medically Tailored Meals Community Support.
Makipag-ugnayan sa DHCS para sa anumang mga tanong o komento tungkol sa California Advancing and Innovating Medi-Cal (CalAIM) Population Health Management initiatives sa PHMSection@dhcs.ca.gov.
Sumali sa Aming Koponan
Ang DHCS ay kumukuha para sa pinansyal, mga mapagkukunan ng tao, parmasya, kalusugan sa pag-uugali, at iba pang mga koponan. Para sa karagdagang impormasyon, mangyaring bisitahin ang website ng CalCareers.
Mga Paparating na Mga Pagpupulong ng Stakeholder at Webinar
Nagpo-post ang DHCS ng mga paparating na pampublikong pagpupulong sa Calendar of Events.
Webinar ng Coverage Ambassador
Sa Marso 25, mula 11 a.m. hanggang 12 p.m. PDT, ang DHCS ay magho-host ng isang webinar ng Coverage Ambassador (kinakailangan ang paunang pagpaparehistro) upang magbigay ng impormasyon tungkol sa mga pagpipilian sa pangangalagang pangkalusugan at mga update sa Medi-Cal. Tumutulong ang mga Coverage Ambassador na maikalat ang salita tungkol sa mga benepisyo ng Medi-Cal, impormasyon sa pagpapatala, at mga bagong proyekto na nakatuon sa paglikha ng isang malusog na California para sa lahat. Mangyaring bisitahin ang website ng Coverage Ambassador para sa karagdagang impormasyon, o mag-subscribe upang maging isang Coverage Ambassador at makatanggap ng mga regular na update.
Managed Long-Term Services and Supports (MLTSS) at Duals Integration Workgroup meeting
On March 27, from 10 a.m. to 12 p.m. PDT, DHCS will host the CalAIM MLTSS and Duals Integration Workgroup meeting (advance registration required). The workgroup is a stakeholder collaboration hub for CalAIM MLTSS and integrated care for dual eligible members. It allows stakeholders to provide feedback and share information about policy, operations, and strategy for upcoming changes to Medi-Cal and Medicare. The meeting agenda includes updates on Medicare enrollment data for dual eligible members, the Dual Eligible Special Needs Plan (D-SNP) Dashboard, D-SNP initiatives, and the D-SNP State Medicaid Agency Contract and Policy Guide. It also includes data updates on Enhanced Care Management and Community Supports for dual eligibles and a Community Supports service spotlight presentation on select service definition updates.
More information, background materials, transcripts, and video recordings of previous workgroup meetings are posted on the CalAIM MLTSS and Duals Integration Workgroup webpage. For questions or comments, please email DHCS at info@calduals.org.
Hearing Aid Coverage for Children Programa (HACCP) Webinar para sa mga Medical Provider at Hearing Professionals
On March 27, from 12 to 1 p.m. PDT, DHCS will host the quarterly HACCP webinar for medical providers and hearing professionals. For more information and to register, please visit DHCS’ HACCP webpage. Registration information will be posted as the webinar date approaches.
Kung sakaling Nalampasan Mo Ito
Bukas Na Ngayon: Pagbibigay ng Access and Transforming Health (PATH) Capacity at Infrastructure Transition, Expansion, and Development (CITED) Round 4 Application
On January 6, DHCS opened the PATH CITED Round 4 application window, which includes funding opportunities to support the implementation of the new transitional rent Community Support. The PATH CITED initiative provides funding to build the capacity and infrastructure of on-the-ground partners, including community-based organizations, hospitals, county agencies, Tribes, and others, to successfully participate in Medi-Cal. All organizations providing the transitional rent Community Support must do so in partnership with their county behavioral health department. To demonstrate this partnership, all CITED applicants planning to request funding to support the transitional rent Community Support must also submit a Letter of Support in collaboration with the county behavioral health department.
Ang deadline para mag-apply para sa PATH CITED Round 4 na pagpopondo ay 11:59 pm PDT sa Mayo 2, 2025. Ang dokumento ng gabay at aplikasyon ay makukuha sa PATH CITED webpage. Mangyaring magpadala ng anumang mga katanungan sa cited@ca-path.com.