DHCS Stakeholder News – May 19, 2023
项目更新
医疗补助计划
On May 19, Reinstatement Phase III, Lift 3 will be implemented, lifting the Transition Policy for 22 Standard Therapeutic Classes (STCs) for members age 22 and older. This is the third in a series of lifts to retire, or phase out, the grandfathering of historical prior authorizations (PA) and claims by reinstating NCPDP Reject Code 75 – Prior Authorization Required.
其余 46 个 STC 的 PA 要求将在第 3 阶段第 4 阶段中恢复，目前计划于 6 月23日2023实施。
2023 年 4 月加州解除劳动合同月度报告
On May 22, DHCS will publish California’s submission of the federal “Unwinding Monthly Report” for the eligibility month of April 2023 to the Centers for Medicare & Medicaid Services (CMS) as part of the continuous coverage unwinding federal requirements. The report includes California’s updated estimate of total pending applications received between March 1, 2020, and March 31, 2023, that are still in a pending status as of April 30; total April 2023 annual renewals and renewal outcomes; and total Medi-Cal fair hearings pending more than 90 days as of April 30. The report also includes a description of California’s renewal timeline and policy during the unwinding period. This report will be posted to the DHCS Medi-Cal Enrollment webpage under “DHCS Continuous Coverage Unwinding Data.” Each monthly report will include the same measures, but specific for that month. DHCS will provide reports to CMS on or about the 20th of each month through at least June 2024.
加入我们的团队
DHCS 目前有两个新的执行职位空缺：
- 人口健康管理司司长，该职位负责人口健康管理计划的战略、政策、监督、监测和评估。
- 质量和健康公平部主管，该职位负责临床质量和健康公平举措、项目评估、质量和公平结果以及 DHCS 项目和交付系统的质量保证和绩效改进活动。
DHCS is dedicated to preserving and improving the overall health and well-being of all Californians. DHCS’ mission is to provide the most vulnerable residents with equitable access to affordable, integrated, high-quality health care, and is currently transforming the Medi-Cal program to make sure it provides the care Californians need to live healthier, happier lives. For more information, please visit the CalCareers website.
即将举行的利益相关方会议和网络研讨会
痴呆症护理意识 – 认知健康评估 (CHA) 虚拟培训
从 5 月 19 日开始，Dementia Care Aware 将在 CHA 上提供每月一次的Zoom 培训（需要提前注册） ，由加州大学欧文分校的老年医学专家指导。 CHA 是一种痴呆症筛查方法，旨在对需要进行认知筛查的老年患者进行。 下一次培训将于6月2日举行。 初级保健提供者和团队可以在每月第一个和第三个星期五加入我们，以了解更多有关 CHA 如何帮助初级保健提供者及其团队更好地检测患者痴呆症的信息。 提供免费的继续医学教育和继续教育单位。
部落和印第安人健康计划代表虚拟会议
On May 22, from 9:30 a.m. to 12 p.m., DHCS will host the quarterly Tribal and Indian Health Program representatives’ virtual meeting (advance registration required). This webinar will include a discussion of DHCS programs and initiatives of interest to tribal partners, and offer a forum to provide feedback on specific aspects of DHCS initiatives that directly affect tribes, Indian Health Programs, and American Indian Medi-Cal members. The next meeting will be held in August in Sacramento. The meeting agenda and other materials will be posted on the Indian Health Program webpage as they become available.
利益相关者咨询委员会 (SAC) 和行为健康利益相关者咨询委员会 (BH-SAC) 会议
5 月 24 日上午 9:30 至下午 3:30，DHCS 将主办SAC 和 BH-SAC 混合会议（需提前注册） 。 它将以联合会议的形式召开，讨论由 SAC 和 BH-SAC 共同讨论的主题。 联席会议后将举行 BH-SAC 专属会议；不会举行 SAC 专属会议。 与会者可以通过线上或线下方式，亲临位于萨克拉门托 K 街 1414 号的加州基金会参加。 如需了解更多信息，请访问SAC和BH-SAC网页。
小组讨论：建立合作伙伴关系，为儿童和青少年推出增强护理管理 (ECM)
6 月 23 日下午 1:00 至 2:30，DHCS 将在 7 月 1 日启动儿童和青少年重点人群 (POF) 的强化护理管理 (ECM) 之前，举办一次关于儿童和青少年强化护理管理 (ECM) 愿景的虚拟活动（需提前注册）。医疗服务提供者、社区组织 (CBO) 和管理性医疗计划 (MCP) 小组将与 DHCS 领导一起提供相关信息：
- 提醒儿童和青少年 POF 的设计和操作指导。
- 提供商如何准备为儿童和青少年 POF 推出 ECM 的示例。
- 为 MCP、县和其他提供商提供有关签订 ECM 福利合同的指导。
本次网络研讨会向公众开放，与会者将有机会在会议期间提问。 这对于刚刚与 MCP 签约的儿童和青少年服务的 MCP 和服务提供商（包括县和 CBO）来说尤其重要。 请于 6 月 19 日之前将问题提交至CalAIMECMILOS@dhcs.ca.gov 。
如果你错过了
California Awards Millions to Strengthen State’s Opioid Response
On May 19, DHCS awarded more than $12 million in grants to strengthen the state’s opioid response as part of the California’s $1 billion plan to tackle the opioid epidemic. The awards include $7.9 million to 20 DHCS-licensed, residential substance use disorder (SUD) treatment facilities throughout the state as part of the Medication Assisted Treatment (MAT) Expansion Project, $3.5 million to 23 organizations through the Tribal Urban Indian Defined Best Practice program, and $1.05 million to seven organizations through the California Native MAT Network for Healing and Recovery.