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.
第 1915(c) 节附录 K 或第 1115 节附件 K 的终止日期因豁免情况而异，但通常不会晚于 PHE 结束后的六个月。同样，DHCS 打算将 1915(c) 和 1115 条款中的一些灵活性措施永久纳入 Medi-Cal 政策，使其在公共卫生紧急状态结束后继续有效。有关这些政策的详细信息，请参阅Medi-Cal COVID-19 PHE 和持续承保运营终止计划的第一部分。
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
2月27日，DHCS开放了PATH TA市场项目资格申请。已提交受益人登记表并被批准为 TA 受益人的 Medi-Cal 服务提供商现在可以通过 Marketplace 购买和申请免费的 TA 服务。TA 服务由首批选定的 47 家独特的供应商提供。他们将协助医疗服务提供者、社区组织 (CBO)、Medi-Cal 部落和印第安人健康计划的指定人员、县以及其他符合条件的 TA 受益人建立和提供成功的增强型护理管理和社区支持。要了解更多信息，请访问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.
此外，DHCS 于 2 月 28 日发布了HACCP 沟通工具包和项目数据仪表板，以支持这些目标。该工具包包括面向符合 HACCP 资格的家庭和医疗服务提供者的社交媒体信息和可打印的宣传材料，以及 DHCS 的HACCP 项目数据网页。更多项目信息请访问DHCS的HACCP网页。
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）。
在符合条件的门诊就诊期间，由符合条件的医疗服务提供者接种的麻疹疫苗，有权按其各自的预付制或全包费率获得报销。提醒医疗服务提供者，每次接种麻疹疫苗要么属于合格的门诊就诊，要么只属于疫苗接种就诊，两者不可兼得。符合条件的医疗服务提供者可以开始为参加 Medi-Cal 管理式医疗计划的成员提交仅接种麻痘疫苗的索赔申请。自 3 月10 、 2023起，医疗服务提供者可以按照 12 月13 、 2022发表的文章“按医疗保险费率报销麻疹疫苗”中的说明，为 FFS 会员提交索赔。医疗服务提供者将获得 120 天的宽限期，可以提交仅针对麻痘疫苗接种的就诊记录。
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。
同时还发布了一份为期 30 天的倒计时警报，标题为“第三阶段提升 1：22 岁及以上受益人过渡政策的终止” ，以宣布 Medi-Cal Rx 恢复计划的下一阶段。提醒大家，Medi-Cal Rx 将于 3 月24 、 2023开始对 22 岁及以上会员实施一系列过渡政策调整。
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.