Повернутися до Оновлення зв’язків із зацікавленими сторонами за квітень 2022 р​​ 

Посли покриття DHCS​​ 

DHCS започаткував заходи по всьому штату, щоб допомогти бенефіціарам Medi-Cal зберегти своє покриття Medi-Cal або бути зареєстрованими в інших програмах.​​ 

In the largest effort of its kind, across the country, Medicaid (e.g., Medi-Cal) and the Children’s Health Insurance Program will soon begin the process of redetermining eligibility for about 85 million people who use these programs to access the health care they need. This large, complex effort will be triggered by the official end of the COVID-19 public health emergency (PHE) and the end of the federal Medicaid continuous coverage requirement that was implemented as part of the Families First Coronavirus Response Act.​​ 

Оскільки Каліфорнія планує відновити звичайні операції щодо відповідності Medi-Cal, приблизно 14,5 мільйонам бенефіціарів потрібно буде повторно визначити їх право на покриття. Наприкінці PHE округи повторно визначать право на участь у програмі Medi-Cal для всіх бенефіціарів на основі дати наступного щорічного поновлення (здійснюється на постійній основі, а не для всіх одразу). У результаті цього процесу два-три мільйони бенефіціарів більше не могли мати право на Medi-Cal.​​ 

DHCS has been actively preparing for this unprecedented event for many months, and has implemented a two-phased communication campaign to reach beneficiaries with messages across multiple channels using trusted partners called DHCS Coverage Ambassadors. DHCS encourages its partners, including local county social services agencies, managed care plans (MCPs), health enrollment navigators, clinics, providers, and community stakeholders, to sign up to serve as DHCS Coverage Ambassadors.​​ 

For Phase 1 of the campaign, DHCS recently launched a customizable Medi-Cal Continuous Coverage toolkit and webpage to help trusted entities and individuals act as DHCS Coverage Ambassadors to provide critical information to beneficiaries and to help preserve health coverage for millions. The toolkit includes social media, call scripts, noticing, and website banners. During Phase 1, trusted entities and individuals encourage beneficiaries to update their contact information with their local county offices, if they have not done so already. Beneficiaries need to know what to expect and what they can do to keep their Medi-Cal health coverage. Those no longer eligible for Medi-Cal may qualify for tax subsidies that allow them to buy affordable Covered California coverage.​​ 

Етап 2 планується запустити приблизно за 60 днів до завершення PHE COVID-19, і він призначений для того, щоб заохотити бенефіціарів оновлювати контактну інформацію та повідомляти про будь-які зміни в обставинах до свого місцевого офісу округу, а також перевіряти свою пошту на предмет майбутніх пакетів поновлення. Коли з’являться додаткові набори інструментів або ресурси, DHCS надішле критичні оновлення електронною поштою, щоб інформувати представників DHCS Coverage Ambassadors, щоб вони могли поширювати інформацію.​​ 

DHCS знає, що буде важливо ділитися інформацією та чути відгуки від вас, оскільки ми разом вживаємо заходів, щоб вийти за межі PHE COVID-19. Нам усім знадобиться спільна робота, щоб допомогти нашим бенефіціарам знати, що вони повинні робити – і коли – для того, щоб зберегти або перейти до свого медичного страхування. Дякуємо за ваше постійне партнерство.​​ 

Програма стимулювання вакцинації від COVID-19 Medi-Cal​​ 

DHCS allocated up to $350 million to incentivize COVID-19 vaccination efforts in the Medi-Cal managed care delivery system from September 1, 2021, through February 28, 2022. Medi-Cal MCPs are eligible to earn incentive payments for activities designed to close vaccination gaps with their enrolled members, and to address vaccine uptake disparities for specific age and race/ethnicity groups. The second outcome ascertainment period for the program ended on January 2. Between November 1 and January 2, the total vaccination rates showed improvement in all reported measures. Statewide, the target (59.2 percent) was exceeded (61.4 percent) for improving the percentage of primary care providers in MCP networks giving the COVID-19 vaccine in their office. On January 2, target goals for all vaccine outcome measures increased to closing two-thirds of the gap between Medi-Cal and county rates, which was a challenge for plans to meet. Three beneficiary sub-groups (ages 12-25 years, African-Americans, and American Indians/Alaska Natives) were successful in closing more than one-third of the gap at this time point, while an additional three groups (overall age 12+ years, 50-64 years, and 65+ years) were within 2 percent of closing one-third of the gap. Specifications for the High Performance Pool program were released to MCPs. For more information, please refer to All Plan Letter (APL) 21-010, Attachment A.​​ 

Розширення для літніх дорослих​​ 

On May 1, California will expand state-funded full-scope Medi-Cal benefits to individuals who are 50 years of age or older, regardless of citizenship or immigration status. This coverage expansion includes approximately 185,000 individuals 50 years of age or older who are currently enrolled in restricted scope Medi-Cal.  Under this coverage expansion, eligible individuals will be able to access the full range of benefits available to Medi-Cal beneficiaries who have full-scope coverage, including no-cost/low-cost quality health, behavioral health, substance use disorder services, and dental services through organized delivery systems under the Medi-Cal program. Enrolled individuals in restricted-scope Medi-Cal who are eligible under this expansion will receive a My Medi-Cal Choice packet in the mail so they can enroll in a Medi-Cal managed care plan for coordinated, integrated medically necessary services. Once enrolled in a plan, they can select a primary care doctor in their plan network. For more information, please visit the DHCS website.​​ 

Опитування охорони здоров’я жителів Каліфорнії віком 55 років і старше​​ 

In April, DHCS will release the results from a survey of California adults ages 55 and older on health care needs, services, and coverage, including Medicare, Medi-Cal, and other health coverage. The survey included questions about respondents’ medical needs, coordination of and access to health care services, caregiver experiences, and the need for and access to in-home care and services. Interviews for this survey were conducted between January 25 and February 10, 2022. A total of 1,540 individuals completed the survey. It was administered by NORC at the University of Chicago, with funding from The SCAN Foundation and oversight from DHCS’ Office of Medicare Innovation and Integration. The survey results will be posted on the DHCS website.​​