2023 年批准的州计划修正案
以下附件是医疗保险和医疗补助服务中心 (CMS) 最近批准的加州州计划的修正案。 利益相关者可以按照文档附带的链接和说明来更新他们的副本。
- 23-0001 Updates the Current Dental Terminology (CDT) code set to CDT-23.
- 23-0002永久授权将 "医院预设资格 "的承保范围扩大至 "65 岁或以上 "且收入达到或低于 138% 联邦贫困线的新承保群体。
- 23-0003 Updates the reimbursement methodology for Durable Medical Equipment.
- 23-0005 Updates existing language to reflect the CDSS updated IHSS policy to allow telehealth reassessments and to update existing language to reflect CDSS IHSS QA updated practices.
- 23-0006更新并修改了针对独立式 B 级专业护理机构 (FS/NF-B) 和独立式亚急 性护理机构 (FSSA) 的现有设施特定补偿方法。
- 23-0007 Provides supplemental payments for private hospital inpatient services for the service period of January 1, 2023 to December 31, 2024.
- 23-0008为私立医院门诊服务提供补充付款，服务期为1年2023月 至31年2024月。
- 23-0009 Extends Medi-Cal eligibility to foster youth from any state who turned 18 years of age on or after January 1, 2023 so long as they otherwise meet the eligibility requirements of being under age 26, enrolled in Medicaid and exiting foster care at age 18 or older.
- 23-0010 Authorizes an Alternative Payment Methodology for Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) and a supplemental payment for Tribal health providers for the provision of eligible dyadic services.
- 23-0012 Disregards, under the authority of section 1902(r)(2) of the Social Security Act, all countable resources for all eligibility groups covered under the state plan to which a resource standard applies.
- 23-0013 Extends and modifies the Private Hospital Supplemental Fund program for the state fiscal year ending in 2024.
- 23-0014 Updates the Medi-Cal reimbursement methodology for State Fiscal Year 2023-24 Diagnosis Related Group Payments.
- 23-0015 Modifies the reimbursement methodology for Medi-Cal behavioral health services.
- 23-0016 Extends the Non-Designated Public Hospital Supplemental Fund program for the state fiscal year ending 2024.
- 23-0017 Reduces the payment cap for supplemental reimbursement to Martin Luther King Jr. – Los Angeles Healthcare Corporation (MLK-LA).
- 23-0019更新临床实验室或实验室服务的报销方法。
- 23-0020授权
23-0020 授权对符合条件的地面紧急医疗转运，在收费表费率的基础上进行补充追加支付。
1,2023 至 6 月30,2024 。 - 23-0022使注册牙科保健师 (RDH)、注册扩展职能牙科保健师 (RDHEF) 和注册替代实践牙科保健师 (RDHAP) 提供的服务与州执业范围法律保持一致。
- 23-0024在 1915(i) 州计划中增加了协调家庭支持作为一项新服务。
- 23-0025阐明了在住院治疗环境中提供的护理协调、康复支持服务、同伴支持专家服务和药物成瘾治疗的报销方法。
- 23-0026更新了康复心理健康服务、目标病例管理、物质使用障碍治疗服务、扩大的物质使用障碍治疗服务、药物辅助治疗和社区移动危机干预服务提供者的类型和资格。
- 23-0027采用学生人事服务认证从业人员作为 Medi-Cal 计划中独特的提供者类型。
- 23-0028更新了独立儿科亚急性 (FS/PSA) 医疗机构的费率制定方法，自 7 月1 、 2023起生效，并将 FS/PSA 费率年份更改为日历年费率年份，自 1 月1 、 2024起生效。
- 23-0029澄清和更新假牙政策分类信息并澄清 Medi-Cal 修复学（可拆卸）一般政策中的豁免情况。
- 23-0030缩小非 MAGI 程序的资产验证系统要求范围。
- 23-0032将指定长期护理机构的报销转移到日历费率年。
- 23-0033允许加州儿童工作机会和责任 (CalWORKs) 受益人轻松加入医疗补助计划，无需单独进行财务资格审核，自 7 月1 、 2023起生效。
- 23-0034澄清了现有的预防服务政策，该政策涉及对经批准的成人疫苗的强制覆盖要求，以符合 CMS 指导。
- 23-0035 Authorizes reimbursement rate increases for primary care, obstetric, and non-specialty mental health services, which are effective for dates of service on or after January 1, 2024.
- 23-0036 Increases rates for independent living programs, adult residential homes and participant-directed day service and supported employment.
- 23-0037将执照专业临床咨询师 (LPCC) 列入在 FQHC、RHC 和部落 FQHC 提供服务的可计费执业人员名单。
在 FQHC、RHC 和部落 FQHC 提供服务的执业医师名单中增加了持证专业临床顾问 (LPCC)。本 SPA 还做了技术性修改，用 "临床心理学家 "代替 "持证临床心理学家"。
心理学家 "取代 "持证临床
心理学家 "和 "持证心理学家"。 - 23-0043 Reimburse providers an ingredient cost, based on a submitted invoice price, for a covered outpatient drug when other pricing benchmarks are unavailable.
- 23-0044 Expands the prescribing authority for enteral formulae from physicians to include physicians, nurse practitioners, clinical nurse specialists, or physician assistants.
- 23-0045 Updates the methodology in which reimbursement for acute psychiatric inpatient hospital services for each Fee-For-Service and Short-Doyle Medi-Cal hospital is determined between the negotiating entity and the servicing hospital.
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