December 22, 2023 – Stakeholder News
Tin tức hàng đầu
Bảng phí sức khỏe hành vi tại trường học đã được công bố
DHCS posted the rates for the Children and Youth Behavioral Health Initiative (CYBHI) statewide multi-payer fee schedule. As part of Governor Newsom’s Master Plan for Kids’ Mental Health and the CYBHI, DHCS, in collaboration with the Department of Managed Health Care and the California Department of Insurance, is expanding access to school-based (or school-linked) outpatient behavioral health services for students.
The fee schedule establishes the minimum rates at which Medi-Cal managed care plans (MCPs) must reimburse local educational agencies (LEAs) and school-linked providers for the provision of behavioral health services to a student under the age of 26 at a school site. School sites could include on-campus, off-campus, and mobile clinic locations. The fee schedule outlines the appropriate billing codes, rates, and provider types for each service type billable as part of the CYBHI fee schedule program. Note: The fee schedule is pending approval of a State Plan Amendment by the federal Centers for Medicare and Medicaid Services (CMS) and is subject to change.
DHCS is phasing in the fee schedule starting in January 2024, when the first cohort of 47 LEAs (announced on December 1, 2023) will go live. The second cohort will go-live in July 2024 and the third cohort in January 2025. Under state law, Medi-Cal MCPs, Medi-Cal Fee-for-Service (FFS), commercial health plans, and disability insurers (collectively referred to as MCPs) are obligated to reimburse eligible school-linked providers, including LEAs and community-based providers contracted by or affiliated with designated by the LEA.
Please visit the CYBHI fee schedule webpage to learn more.
Cập nhật chương trình
Tăng tỷ lệ nhà cung cấp mục tiêu Medi-Cal đã được chấp thuận
On December 19, 2023, CMS approved State Plan Amendment (SPA) 23-0035, authorizing DHCS to provide targeted rate increases for primary/general care, obstetric, doula, and non-specialty mental health services effective January 1, 2024. Pursuant to Assembly Bill (AB) 118 (Chapter 42, Statutes of 2023), DHCS increased rates for targeted services to no less than 87.5 percent of the Medicare rate, inclusive of eliminating AB 97 provider payment reductions and incorporating applicable Proposition 56 supplemental payments into the base rate.
For more information, including the 2024 Targeted Rate Increase Fee Schedule and approved SPA 23-0035, please visit the Medi-Cal Targeted Provider Rate Increase webpage.
Chương trình Phí đảm bảo chất lượng bệnh viện (HQAF) VIII đã được phê duyệt
On December 15, 2023, and December 19, 2023, CMS approved the HQAF SPA 23-0007, SPA 23-0008, and broad-based and uniformity tax waiver letter, respectively, authorizing the HQAF VIII program supplemental payments to be made to California private hospitals up to the aggregate upper payment limit for the period of January 1, 2023, through December 31, 2024.
The HQAF program was established in 2009 with the aim of improving hospital reimbursement for services provided to Medi-Cal members. For services provided during calendar years 2023 and 2024, the HQAF program is estimated to provide private hospitals with approximately $21 billion in federally matched supplemental payments for inpatient and outpatient services and increased capitation payments to managed care plans. In addition, the program generates funding for children’s health care coverage and public hospital grants.
DHCS will publish on its website information related to the HQAF VIII program, including the SPA, Fee and Payment model, and other pertinent information. HQAF VIII will continue to provide much needed funding and enhance Medi-Cal beneficiaries’ access to health care throughout California. To learn more about the program, please visit the HQAF website, and please e-mail questions to HQAF@dhcs.ca.gov.
Nguồn lực mới cho chương trình Medi-Medi Plan Outreach
DHCS released two new Sign-Language YouTube videos for members dually eligible for Medicare and Medi-Cal. Both videos are sign language interpretations: “Joining a Medi-Medi Plan” is in American Sign Language and “Inscibirse a un Plan de Medi-Medi” is in Mexican Sign Language.
Californians in twelve counties are eligible to enroll in Medicare-Medi-Cal Plans (Medi-Medi Plans), a type of Medicare Advantage plan in California that is only available to dual-eligible members. Medi-Medi Plans provide more comprehensive care to individuals dually eligible for Medicare and Medi-Cal, and benefits in both programs are coordinated by one managed care organization (MCO). In 2024, Medi-Medi Plans are available in the following counties: Fresno, Kings, Los Angeles, Madera, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Mateo, Santa Clara, and Tulare.
Additional information is available on the DHCS Medi-Medi Plan webpage.
Cung cấp khả năng tiếp cận và chuyển đổi sức khỏe (PATH) và chuyển đổi cơ sở hạ tầng, mở rộng và phát triển (CITED) Vòng 3 đơn đăng ký sẽ sớm ra mắt
On January 15, 2024, DHCS plans to open the PATH CITED Round 3 application window. The PATH CITED initiative provides funding to build the capacity and infrastructure of on-the-ground partners delivering Medi-Cal enhanced care management (ECM) benefits and community support services. The deadline to apply for CITED Round 3 funding is currently scheduled for February 15, 2024.
On December 18, 2023, DHCS published the PATH CITED Round 3 application outline to help prospective applicants prepare the resources and information required to complete their application. The CITED Round 3 application window is expected to open on January 15, 2024, for 30 days. Round 3 eligible entities include community-based organizations; county, city, or local government agencies; federally qualified health centers; Medi-Cal Tribal and Designee of Indian Health Program; providers; and others as approved by DHCS. Visit the PATH CITED website to learn more.
Tham gia nhóm của chúng tôi
DHCS đang tuyển dụng. DHCS có cơ hội cho:
- Assistant Deputy Director for Program Operations assists in leading, planning, organizing, and directing Program Operations, which is comprised of the California Medicaid Management Information System – Operations, Clinical Assurance, Provider Enrollment, and Third-Party Liability and Recovery Divisions. (Final filing date (FFD) is December 29)
- Chief of Capitated Rates Development within Health Care Financing serves as the principal policymaker for all rate-setting activities to ensure high-quality and cost-efficient health care through DHCS’ contracted Medi-Cal MCPs. (FFD extended to December 26)
- Trưởng phòng Phát triển Giá Phí cho Dịch vụ trong Tài chính Chăm sóc Sức khỏe phát triển, diễn giải và ban hành chính sách về phương pháp hoàn trả Medi-Cal cho các dịch vụ chăm sóc phi tổ chức và dài hạn và các chương trình phí nhà cung cấp dịch vụ Medi-Cal (FFS). (FFD kéo dài đến ngày 26 tháng 12)
DHCS cũng đang tuyển dụng nhân sự, kiểm toán, chính sách y tế, công nghệ thông tin và các nhóm khác. Để biết thêm thông tin, vui lòng truy cập trang web CalCareers.
Trong trường hợp bạn bỏ lỡ nó
LIÊN KẾT ĐÃ SỬA: Báo cáo tóm tắt lập pháp DHCS 2023
On December 15, DHCS released the 2023 Legislative Summary report. This report provides a summary of chaptered and vetoed legislation for all significant bills the Department analyzed and engaged with during the first year of the 2023-2024 legislative session. Please note, this report does not represent a complete listing of bills the Department followed, nor any bills that did not make it to the Governor’s desk.
DHCS trao tặng 150 triệu đô la để hỗ trợ các chương trình sức khỏe tâm thần cho thanh thiếu niên và người trưởng thành trẻ tuổi
On December 21, DHCS awarded $150 million to 262 organizations to support wellness and build resilience of children, youth, and young adults.
The awards, funded as part of the CYBHI Evidence-based Practices (EBP) and Community-defined Evidence Practices (CDEP) Grant Program, focus on equity and centering efforts around youth and young adult voices, strengths, needs, priorities, and experiences, especially for those most at risk. They also drive transformative systems change and use ongoing learnings as the basis for change and improvement in outcomes for children and youth. DHCS posted the full list of grantees for Round Two: Trauma Informed Programs and Practices and Round Four: Youth Driven Programs.
Chuyển đổi Medi-Cal MCP tháng 1 năm 2024
As part of Medi-Cal transformation, some MCPs are changing on January 1, 2024, and approximately 1.2 million members will have new health plan options and/or will need to transition to new MCPs. Changing MCPs will not affect Medi-Cal member coverage or benefits. Members transitioning to a new MCP received notices about the transition. DHCS developed several resources to support members, providers, and other stakeholders with the transition, including the Managed Care Plan Transition Member webpage with a county “lookup” tool, links to member notices sent by Medi-Cal about MCP changes, frequently asked questions, and a Contact Us page for members to learn more about health plans and provider choices. There are also transition resources for providers and MCPs and stakeholders. More information about the transition is available in the 2024 Managed Care Plan Transition Policy Guide and Medi-Cal Eligibility Division Information Letter Number I 23-54.