Tin tức hàng đầu​​ 

Báo cáo Đạo luật Dịch vụ Sức khỏe Hành vi Mới (BHSA) Hỗ trợ Ổn định Doanh thu và Lập kế hoạch​​ 

DHCS released the BHSA Revenue Stability Workgroup Report with recommendations to reduce the variance of county Behavioral Health Services Funds (BHSF). The recommendations are intended to help counties manage revenue more consistently, maintain services through economic ups and downs, and bring greater predictability and accountability to local behavioral health care funding.​​ 

The BHSA Revenue Stability Workgroup, comprising state leaders and counties, was required to develop and recommend solutions to reduce BHSA revenue volatility and propose appropriate prudent reserve levels to support the sustainability of county programs and services. It reviewed and analyzed current and historical revenues generated by the MHSA and the BHSA and prudent reserve levels to develop the recommendations.​​ 

The State Controller’s Office will continue to follow the current process to distribute BHSA local assistance funds to counties monthly. The goal is to balance local assistance revenue allocation and program stability, helping counties effectively plan and provide critical behavioral health services during revenue downturns. Highlights include:​​ 

• Mức chi tiêu hàng năm dựa trên mức trung bình ba năm, điều chỉnh theo lạm phát.​​ 
• Giới hạn dự trữ mới (10-15 phần trăm, tùy thuộc vào quy mô quận).​​ 
• Yêu cầu một lần phải chi hết dự trữ vượt mức trong giai đoạn 2026–2029.​​ 
• Linh hoạt điều chỉnh ngân sách nếu doanh thu giảm.​​ 
• Minh bạch hơn, yêu cầu báo cáo công khai và ý kiến đóng góp của cộng đồng.​​ 

This approach supports California’s Mental Health for All vision by promoting stability, transparency, and community-centered behavioral health care. State legislation is required to enact recommendations from the BHSA Revenue Stability Workgroup Report.​​ 

Cộng đồng ủng hộ việc thể hiện hiệu quả về chi phí sớm trong khi đáp ứng nhu cầu của thành viên Medi-Cal​​ 

DHCS recently submitted to the Centers for Medicare & Medicaid Services (CMS) its Community Supports, or In Lieu of Services (ILOS), Annual Report[TO1] , which reviews the progress and impact of Medi-Cal Community Supports in 2024. For the first time, the report also includes a cost-effectiveness analysis for 2023. The report highlights key achievements, such as reduced emergency room visits, hospitalizations, and long-term care use, pointing to early evidence of both improved health outcomes and reduced costs when compared to the services they are replacing, such as inpatient, emergency department, and long-term care services. Of the 12 Community Supports studied, nine are already proving cost-effective, and the remaining three are expected to prove to be cost-effective over time.​​ 

The report also outlines operational improvements made by DHCS and managed care plans (MCP) to expand services, grow provider networks, and support implementation. While progress has been significant, the report also identifies ongoing challenges and opportunities for further improvement, ensuring these services continue to evolve to meet the needs of Medi-Cal members.​​ 

Cập nhật chương trình​​ 

Cập nhật về việc mua sắm MCP thương mại Medi-Cal​​ 

DHCS will postpone the next commercial Medi-Cal MCP procurement by at least two years. The next competitive procurement for MCPs will begin no sooner than 2029, with contracts expected to take effect no sooner than 2031. DHCS previously indicated that the re-procurement for commercial MCPs would be conducted once every five years. Under this assumed timeline, DHCS would have had to release the Request for Proposal (RFP) in 2027 for a contract effective date of January 1, 2029.​​ 

The additional time will allow DHCS to focus on critical California Advancing and Innovating Medi-Cal (CalAIM) initiatives. It will also help maintain stability for members and support ongoing improvements to care quality and access, while also supporting the long-term success of the Medi-Cal managed care program.​​ 

In accordance with current policy, MCP contracts will be renewed annually following the contractual requirements identified in Exhibit E, 1.1.15 of the 2024 Managed Care Boilerplate Contract. Current MCP contracts will be extended from January 1, 2026, to December 31, 2026, by the established annual process. DHCS remains committed to fostering an inclusive, flexible, and responsive process that supports the Medi-Cal program and ensures continued equitable access to high-quality care for Californians. Please visit the Medi-Cal Managed Care webpage for more information.​​ 

Chuyển đổi Chăm sóc Quản lý Nha khoa​​ 

During the week of May 26, DHCS will mail a 30-day notice to about 350,000 Medi-Cal members in Sacramento and Los Angeles counties to notify them of upcoming changes to their dental service delivery, effective July 1, 2025. The member notice explains what is changing, if the member needs to make a plan choice, the member’s continuity of care protections, and other important information, and will include a Medi-Cal managed care enrollment packet.​​ 

Members in Sacramento County who are currently enrolled in Access Dental Plan or dental fee-for-service (FFS) must select a new Dental Managed Care plan, while members in Los Angeles County who do not choose a Dental Managed Care plan will remain in FFS. Members currently enrolled with Health Net or Liberty will not be affected by these changes. Additionally, changing Dental Managed Care plans will not affect Medi-Cal coverage or benefits.​​ 

Medi-Cal Health Care Options is conducting an outbound call campaign to members who receive a managed care enrollment packet. During these calls, HCO representatives will review available Dental Managed Care plan choices, answer questions, and facilitate enrollment in the member’s chosen plan over the phone. DHCS developed the Dental Transition Member Notices webpage for members to view notices and other information about the Dental Managed Care transition.​​ 

Yêu cầu và thủ tục ghi danh Medi-Cal cho các nhà cung cấp dược phẩm​​ 

Effective August 1, 2025, pharmacy providers that hold a valid Clinical Laboratory Improvement Amendments (CLIA) Certificate of Waiver and current Certificate of California Clinical Laboratory Registration may bill for CLIA-waived tests provided within the pharmacist’s scope of practice as defined by the California State Board of Pharmacy and authorized in Business and Professions Code Section 4052.4. Pharmacy providers must apply to enroll in the Medi-Cal program by submitting a Medi-Cal provider enrollment online application, along with all supporting documentation.​​ 

On June 10, from 10 to 11 a.m. PDT, DHCS will hold a public stakeholder hearing via webinar (advance registration required) to discuss the draft regulatory provider bulletin entitled, “Medi-Cal Enrollment Requirements and Procedures for Pharmacy Providers that Hold a Clinical Laboratory Improvement Amendments (CLIA) Certificate of Waiver.”​​ 

Written comments, questions, or suggestions may be submitted during the hearing in the webinar chat. For those unable to attend, written comments must be submitted by 5 p.m. PDT on June 10 to be considered for publication. When submitting written comments, please ensure that the commenter and organization/association being represented are both identified in the comments. Please submit written comments to DHCSPEDStakeholder@dhcs.ca.gov. Based on the public comments received, DHCS will publish the final bulletin on the Medi-Cal providers and DHCS Provider Enrollment Division websites.​​ 

Tham gia nhóm của chúng tôi​​ 

DHCS đang tìm kiếm một cá nhân tài năng và có động lực để phục vụ như sau:​​ 

• Trưởng phòng Phát triển giá theo đầu người. Người đứng đầu lãnh đạo các hoạt động thiết lập mức giá cho các chương trình chăm sóc sức khỏe được quản lý của Medi-Cal và các chương trình chăm sóc toàn diện cho các tổ chức người cao tuổi. Các hoạt động bao gồm triển khai các phương pháp tính toán để thiết lập tỷ lệ theo đầu người và giám sát việc phát triển và thực hiện các chính sách và giao thức hoàn trả. Ngoài ra, Trưởng phòng còn đảm bảo các phương pháp tài chính phù hợp với việc cung cấp dịch vụ chăm sóc sức khỏe chất lượng hiệu quả và tuân thủ luật pháp, quy định và quy tắc của tiểu bang và liên bang. Đơn đăng ký phải được nộp trước ngày 30 tháng 5.
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• Assistant Deputy Director (ADD), Enterprise Technology Services (ETS). This new ADD role will build collaborative working relationships with DHCS Executive Staff, program partners, and external stakeholders, and assist with leading DHCS’ IT programs and services. Additionally, the ADD will play a vital role in leading the development and implementation of IT policies, system architecture, security, improvements, and solutions for DHCS programs, including Medi-Cal and behavioral health. Applications must be submitted by June 2.​​ 

DHCS is hiring for its Medi-Cal managed care, data analytics, Medi-Cal eligibility, and other teams. For more information, please visit the CalCareers website.​​ 

Các cuộc họp và hội thảo trực tuyến sắp tới của các bên liên quan​​ 

DHCS posts upcoming public meetings on the Calendar of Events. DHCS provides free assistive services, including language interpretation, real-time captioning, and alternate formatting of meeting materials. To request services, please email DHCS at the appropriate contact email address at least ten working days before the meeting.​​ 

Hội thảo trực tuyến của Đại sứ bảo hiểm: Con đường chăm sóc khi sinh nở​​  

On May 29, from 11 a.m. to 12 p.m. PDT, DHCS will hold a Coverage Ambassador webinar that will focus on DHCS’ Birthing Care Pathway initiative (advance registration required). The webinar will provide information about maternity services for pregnant and postpartum Medi-Cal members from conception through 12 months postpartum and review highlights from the Birthing Care Pathway Report released on February 4. This initiative helps to ensure Medi-Cal members have access to high-quality, equitable care to improve maternal health outcomes and reduce disparities. Coverage Ambassadors will also learn about DHCS’ social media platforms, which offer up-to-date information on relevant topics that can benefit both Coverage Ambassadors and Medi-Cal members. Simultaneous interpretation in Spanish will be offered during the webinar.​​ 

Trong trường hợp bạn bỏ lỡ nó​​ 

Yêu cầu nộp đơn (RFA): Quỹ trợ cấp nhà ở linh hoạt​​  

On May 7, DHCS announced the Flexible Housing Subsidy Pools (“Flex Pools”) RFA. DHCS will select up to 10 local teams to participate in the Flex Pools TA Academy and receive Flex Pools planning grants of approximately $150,000. The launch of Medi-Cal Transitional Rent and Behavioral Health Services Act (BHSA) Housing Interventions creates an unprecedented opportunity to help people achieve better health outcomes through housing stability.​​ 

Flex Pools are intended to help counties and Tribal entities improve housing stability for individuals experiencing or at risk of homelessness. They are a locally designed model to coordinate rental assistance and make the best use of available housing supports, aligning the work of managed care plans, county behavioral health agencies, and other key partners in the homeless services and rehousing systems. Applications are due to DHCS by 5 p.m. PDT on June 13, 2025. Organizations selected will be notified in July 2025. To learn more and apply, please visit the DHCS Housing for Health website.​​ 

Đơn xin sửa đổi miễn trừ HCBA – Thời gian bình luận công khai trong 30 ngày​​ 

On May 12, DHCS posted a draft of the 2025 Home and Community-Based Alternatives (HCBA) waiver amendment for a 30-day public comment period, prior to submitting the final version to CMS for reauthorization. The HCBA waiver allows eligible enrollees to receive approved services via the telehealth delivery system. Proposed changes in the waiver amendment include:​​ 

• Làm rõ hướng dẫn và kỳ vọng đối với dịch vụ chăm sóc sức khỏe từ xa.​​ 
• Xóa bỏ các chế độ phúc lợi và điều kiện không phụ thuộc vào lỗ thông hơi và lỗ thông hơi của Cơ sở chăm sóc trung gian dành cho người khuyết tật phát triển - Điều dưỡng liên tục (ICF/DD-CN), vì chúng đang được chuyển sang Kế hoạch tiểu bang Medicaid dưới dạng phúc lợi chăm sóc dài hạn.​​ 

This transition advances California’s efforts to comply with the federal Medicaid Home and Community-Based Settings (HCBS) Final Rule by reinforcing the delivery of services in integrated, community-based settings that support individual choice and autonomy.​​ 

DHCS invites all interested parties to review the amendments and comment instructions on the DHCS HCBA Waiver webpage under the HCBA Waiver Amendment Application – 30-Day Public Comment from May 12, 2025 – June 12, 2025 heading. All comments must be received by June 12, 2025. If you have any questions, please email hcbspolicy@dhcs.ca.gov.​​ 

Bản sửa đổi Kế hoạch Tiểu bang Medicaid (SPA) – Thời gian bình luận công khai 30 ngày​​  

On May 12, DHCS posted the ICF/DD-CN: Transition of Benefit/Setting SPA (SPA #25-0026) for a 30-day public comment period, prior to submitting the final version to CMS for approval. ICF/DD-CNs provide 24-hour personal care, developmental services, and nursing supervision for individuals with developmental disabilities who have continuous needs for skilled nursing care and have been certified by a physician and surgeon as warranting continuous skilled nursing care. This service is currently provided through the HCBA waiver. This SPA will transition the ICF/DD-CN benefit/setting from the HCBA waiver to the Medicaid State Plan as a long-term care setting. This transition advances California’s efforts to comply with the federal HCBS Final Rule by reinforcing the delivery of services in integrated, community-based settings that support individual choice and autonomy. All comments must be received by June 12, 2025. If you have any questions, please email PublicInput@dhcs.ca.gov.​​