DHCS Stakeholder Update – March 3, 2023
Top News
End of the Public Health Emergency (PHE): Key Medicaid and Children’s Health Insurance Program (CHIP) Dates
The announcement that the federal COVID-19 PHE will end on May 11, 2023, has implications for Medicaid and CHIP programs. Additionally, DHCS is acting to make permanent several flexibilities implemented over the course of the PHE. Below is a summary of end dates for key federal Medicaid provisions, with additional details on how DHCS is unwinding the PHE in the Medi-Cal program.
关于美国救援计划法案 (ARPA) 下的 Medicaid 和 CHIP COVID-19 规定：
Optional COVID-19 Group for Uninsured Individuals: California has taken advantage of the “optional COVID-19 group” that provides uninsured individuals with Medi-Cal coverage for COVID-19 vaccines, testing, and treatment. This coverage expires on the last day of the PHE (May 11). In order to prepare individuals in this group for the end of the PHE, DHCS will send member notices on April 24, 2023.
No-Cost Coverage for COVID-19 Vaccines, Testing, and Treatment to Members: Medicaid is required to cover COVID-19 vaccines, testing, and treatment with no cost-sharing for members through the last day of the first calendar quarter that begins one year after the last day of the COVID-19 PHE. DHCS is electing to permanently extend coverage for COVID-19 vaccines, testing, and treatment at no cost beyond the ARPA coverage period.
Enhanced Federal Match for COVID-19 Vaccines and Vaccine Administration: States receive 100 percent federal matching funds for coverage of vaccines and vaccine administration, as enacted by ARPA. These matching funds also end on the last day of the first calendar quarter that begins one year after the last day of the COVID-19 PHE (September 30, 2024). As described above, Medi-Cal will continue to cover COVID-19 vaccine and vaccine administration.
关于 PHE 实现的法定灵活性：
Section 1135 waivers expire at the end of the PHE (May 11). Medicaid programs are unable to extend flexibilities authorized under 1135 waivers. Additionally, DHCS is electing to discontinue emergency Medi-Cal provider enrollment flexibilities, effective March 29, 2023, as recently announced.
Medicaid Disaster Relief State Plan Amendments (SPAs) typically expire at the end of the PHE (May 11), but DHCS is making permanent many policies authorized under Disaster Relief SPAs. For details on the specific policies that are being made permanent through the traditional SPA process, please see Part I of the Medi-Cal COVID-19 PHE and Continuous Coverage Operational Unwinding Plan.
Section 1915(c) Appendix K or Section 1115 Attachment K termination dates vary by waiver, but typically will be no later than six months after the end of the PHE. Similarly, DHCS intends to make some 1915(c) and 1115 flexibilities permanent Medi-Cal policies beyond the end of the PHE. For details on these policies, please see part I of the Medi-Cal COVID-19 PHE and Continuous Coverage Operational Unwinding Plan.
项目更新
现已开放：提供获取和转变健康 (PATH) 技术援助 (TA) 市场申请
On February 27, DHCS opened the PATH TA Marketplace Project Eligibility Application. Medi-Cal service providers who submitted the Recipient Registration Form and have been approved as a TA recipient may now shop and apply for no-cost TA services through the Marketplace. TA services are being offered by an initial selection of 47 unique vendors. They will assist providers, community-based organizations (CBOs), Medi-Cal Tribal and Designees of Indian Health Programs, counties, and other eligible TA recipients build and deliver successful Enhanced Care Management and Community Supports. To learn more, visit ca-path.com/ta-marketplace.
PATH Capacity and Infrastructure Transition, Expansion, and Development (CITED) Round 2 Application Now Open
On February 28, DHCS opened the PATH CITED Round 2 application window. The PATH CITED initiative provides funding to on-the-ground partners, such as CBOs, public hospitals, county agencies, Tribes, and others to help them successfully participate in the Medi-Cal delivery system. New companies are encouraged to become Medi-Cal providers to deliver Enhanced Care Management and Community Supports. Entities interested in applying for Round 2 are encouraged to join the upcoming informational webinar on March 3, from 10 to 11 a.m., to learn more about CITED funds and the application process. The deadline to apply for CITED Round 2 funding is May 31, 2023.
Please visit ca-path.com/cited to apply and for more information. For questions, please email cited@ca-path.com.
儿童助听器覆盖计划 (HACCP) 行动计划和通讯工具包
On March 1, DHCS released the HACCP Action Plan, which provides an overview of DHCS’ comprehensive strategy on HACCP improvements in 2023 with actionable tactics to improve provider participation and increase program enrollment.
Also, on February 28, DHCS published the HACCP Communications Toolkit and Program Data dashboard to support these objectives. The toolkit includes social media messaging and printable outreach materials for HACCP-eligible families and medical providers, and DHCS’ HACCP Program Data webpage. Additional program information is available at DHCS’ HACCP webpage.
Monkeypox (Mpox) Vaccine Administration
医疗保险和医疗补助服务中心 (CMS) 最近批准了 SPA 22-0062，以按服务收费 (FFS) 的费率报销联邦合格医疗中心 (FQHC)、农村卫生诊所 (RHC)、印度健康服务备忘录 (IHS-MOA) 和部落 FQHC 诊所提供者的疫苗接种费用。 其有效期追溯至17年2022月，并延续至 Mpox 州公共卫生紧急事件结束（ 31年2023年 1 月）。
Mpox vaccines administered during a qualifying office visit to eligible providers are entitled to reimbursement at their individual Prospective Payment System or All-Inclusive rates. Providers are reminded that each administration of the Mpox vaccine either falls under a qualifying office visit or vaccine-only encounter, not both. Eligible providers may begin submitting claims for members enrolled in Medi-Cal managed care plans for Mpox vaccine-only encounters. Effective March 10, 2023, providers may submit claims for FFS members pursuant to instructions published in the December 13, 2022, article “Mpox Vaccines Reimbursement at the Medicare Rate”. Providers will receive a 120-day timeliness override to submit the Mpox vaccine-only encounters.
医疗补助计划
年 2 月24日2023 ，Medi-Cal Rx 恢复计划第 II 阶段第 2 波成功实施。 医疗服务提供者必须提交另外 46 种药品类别（包括医疗用品）的预先授权，以及针对 22 岁及以上会员的新开始药物的预先授权。
A 30-day countdown alert, entitled Phase III Lift 1: Retirement of the Transition Policy for Beneficiaries 22 Years of Age and Older, was also released to announce the next phase of the Medi-Cal Rx Reinstatement Plan. This is a reminder that Medi-Cal Rx will initiate the first of a series of transition policy lifts for members ages 22 and older starting on March 24, 2023.
加入我们的团队
DHCS is hiring for our fiscal, human resources, legal, auditing, health policy, and information technology teams. For more information, please visit the CalCareers website.
DHCS 致力于维护和改善所有加利福尼亚人的整体健康和福祉。
DHCS 的使命是为最弱势的居民提供公平获得负担得起的、综合的、高质量的医疗保健的机会，目前正在改变 Medi-Cal 计划，以确保它为加州人提供过上更健康、更快乐的生活所需的医疗服务。
即将举行的利益相关方会议和网络研讨会
护理机构融资改革网络研讨会
On March 10, from 1:30 to 2:30 p.m., DHCS will host a stakeholder webinar (advance registration required) to discuss the development of the Workforce Standards Program and present an update on the Workforce and Quality Incentive Program. Additional information is posted on the Nursing Facility Financing Reform (AB 186) webpage.
如果你错过了
California Awards $4.6 Million to Emergency Departments (EDs) to Train Behavioral Health Navigators
On March 1, DHCS awarded more than $4.6 million to 39 hospitals with EDs, each receiving $120,000 to train behavioral health navigators to help expand access to substance use disorder and mental health services. The awards are part of DHCS’ CalBridge Behavioral Health Navigator Program. CalBridge is funded by the American Rescue Plan Act of 2021 under key initiatives for Medi-Cal’s Home and Community-Based Services, and aims to train and expand the ED workforce to address the urgent need for behavioral health patient care. These awards are part of a larger effort by CalHHS to strengthen California’s health and human services workforce.