CalAIM 行为健康计划常见问题解答
以下是从技术援助和信息网络研讨会以及提交到BHCalAIM@dhcs.ca.gov电子邮件中收集的常见问题列表。 DHCS 将每季度更新此列表。
谅解备忘录（MOU）
向 DHCS 提交 MCP、MHP 和 DMC-ODS 季度报告的流程是什么？
Managed Care Plans (MCPs) must demonstrate a good faith effort to meet the Memorandum of Understanding (MOU) requirements of All Plan Letter (APL) 23-029. MCPs that are unable to execute the required MOUs by the required execution date must submit quarterly progress reports and documentation to DHCS demonstrating evidence of their good faith effort to execute the MOUs. The other Parties are not required to submit or sign the MCP’s quarterly reports, as the quarterly reports are specific to the MCPs compliance with the MOU requirements. DHCS has released an MOU Quarterly Reporting Template and instructions for submitting the required quarterly reports with the finalized template.
MHPs and DMC-ODS counties must demonstrate a good faith effort to meet the MOU requirements of Behavioral Health Information Notices (BHINs) and 23-057, respectively. MHPs and DMC-ODS counties that are unable to execute the required MOUs by January 1, 2024 must submit quarterly progress reports and documentation to DHCS demonstrating evidence of their good faith effort to execute the MOUs. The deadline for the first quarter submissions for MHPs and DMC-ODS counties is April 30, 2024. Please refer to BHIN 23-056 and 23-057 for the progress quarterly report submission deadline to DHCS. MHP and DMC-ODS counties shall submit the quarterly progress report to MCBHOMDMonitoring@dhcs.ca.gov. The quarterly updates will be required until the MOU is executed and all policies and procedures required by the MOU are established and submitted to DHCS.23-056 and 23-057, respectively. Mental Health Plans (MHPs) and Drug Medi-Cal-Organized Delivery System (DMC-ODS) counties that are unable to execute the required MOUs by January 1, 2024 must submit quarterly progress reports and documentation to DHCS demonstrating evidence of their good faith effort to execute the MOUs. The deadline for the first quarter submissions for MHPs and DMC-ODS counties is April 30, 2024. Please refer to BHIN 23-056 and 23-057 for the progress quarterly report submission deadline to DHCS. MHP and DMC-ODS counties shall submit the quarterly progress report to MCBHOMDMonitoring@dhcs.ca.gov. The quarterly updates will be required until the MOU is executed and all policies and procedures required by the MOU are established and submitted to DHCS.
Are MHPs and DMC-ODS county network/contracted providers required to be signatories to their delivery system’s respective MOU?
No. The required signatories (in addition to the Mental Health Plan (MHP) / Drug Medi-Cal-Organized Delivery System (DMC-ODS) County and the Managed Care Plans (MCPs)) are MCP Subcontractors or Downstream Subcontractors that are Knox-Keene licensed health care plans and have entered into agreements with MCPs to delegate all or part of their responsibilities relating to sending/receiving referrals and care coordination for members served by both parties of the Memorandum of Understanding (MOU). In addition, the MHP’s behavioral health director (or position above) or a designated member of the county’s Board of Supervisors must sign the MOU. This does not include network/contracted MHP and DMC-ODS providers.
MCP、MHP 和 DMC-ODS 县是否需要提交模板所有更新的红线版本，包括使用可选条款？
对于管理式医疗计划 (MCP)、精神健康计划 (MHP) 和药物 Medi-Cal 有组织的配送系统 (DMC-ODS) 县，在执行之前不需要红线版本和对可选条款和附加内容的事先批准。 但是，MCP、MHP 和 DMC-ODS 县需要一张封面，清楚地显示任何附加或可选条款。 DHCS 正在开发供 MCP、MHP 和 DMC-ODS 县使用的封面。 该封面将包括所有选定的可选条款，以及 MCP、MHP 和 DMC-ODS 县标注任何附加条款的能力。 DHCS 将通过技术援助和更新谅解备忘录 (MOU) 常见问题解答来传达这些要求。
BHIN 23-056和23-057中包含的 MHP 和 DMC-ODS MOU 模板是否与APL 23-029中包含的 MHP 和 DMC-ODS MOU 模板以及 MCP MOU 网站上的 MHP 和 DMC-ODS MOU 模板相同？
是的，行为健康信息通知 (BHIN)、所有计划信函 (APL) 和网站中引用的精神健康计划 (MHP) 和药物 Medi-Cal 组织交付系统 (DMC-ODS) 谅解备忘录 (MOU) 模板是相同的。