April 29. 2024 – Stakeholder Update
热门新闻
DHCS 庆祝行为健康治疗中心剪彩
On April 25 and 26, DHCS celebrated the addition of two new facilities that will provide lifesaving treatment for Californians with mental health and substance use disorders (SUD). Paving the Way Foundation in Los Angeles County and Center Point Drug Abuse Alternatives Center in Sonoma County are expanding behavioral health treatment and recovery options in their local communities. These are among the first of many community treatment sites supported by the Behavioral Health Continuum Infrastructure Program and are under construction now in 49 counties. Even more sites will be funded and built, thanks to recently approved Proposition 1 bonds.
项目更新
Medi-Cal Rx 索赔的新代码 1 诊断要求
Effective April 30, Code 1 Diagnosis Requirement – Reject Code 80 claim utilization management (UM) edits will be implemented for members 22 years of age and older. Medi-Cal Rx will use diagnosis code(s) from the member’s Medi-Cal medical record to meet the Code 1 diagnosis restriction. Code 1 drugs are subject to prescription documentation requirements, and prescribers and pharmacy providers must document the treatment diagnosis and keep that information readily available for auditing purposes. Code 1 diagnosis requirements can be met in one of four ways: provide a diagnosis with the prescription, communicate the diagnosis verbally to the pharmacy provider, submit a prior authorization request with the diagnosis, or use an acceptable diagnosis code that is on file in the Medi-Cal data system. Members 21 years of age and younger are not impacted.
微笑，加州流动牙科车之旅继续
On May 4, the Smile, California mobile dental van tour will stop in Huntington Park. During the event, individuals will have access to various dental services, such as exams, X-rays, cleaning, and fluoride applications. More information about Medi-Cal-covered dental services is available on the Smile, California website.
加入我们的团队
DHCS 正在招聘通讯、人力资源、审计、卫生政策、信息技术和其他团队的人员。 欲了解更多信息，请访问CalCareers 网站。
即将举行的利益相关方会议和网络研讨会
Medi-Cal Children’s Health Advisory Panel (MCHAP)
On May 1, from 10 a.m. to 2 p.m., DHCS will hold the MCHAP hybrid meeting (advance registration required). MCHAP advises DHCS on policy and operational issues that affect children in Medi-Cal. The panel consists of a 15-member advisory body whose members include recognized stakeholders and experts in their fields, medical professionals, advocates, and parent members. If you are interested in receiving information about MCHAP meetings or have general inquiries, please email MCHAP@dhcs.ca.gov.
以消费者为中心的利益相关者工作组 (CFSW)
On May 3, from 10 to 11:30 a.m., DHCS will convene the CFSW, which provides stakeholders an opportunity to review and provide feedback on a variety of consumer messaging materials. The forum focuses on eligibility- and enrollment-related activities and strives to offer an open discussion on Medi-Cal policies and functionality. Meeting materials, including the meeting agenda, will be posted to the CFSW webpage no later than May 1. Please email your questions to DHCSCFSW@dhcs.ca.gov.
Medi-Cal Dental 洛杉矶利益相关者会议
5 月 14 日下午 1 点至 3 点，DHCS 将主办 Medi-Cal Dental 洛杉矶利益相关者会议。 DHCS 将分享有关新活动和即将开展的活动的最新消息和信息。 会议还为牙科利益相关者提供了一个论坛，让他们与 Medi-Cal 牙科团队分享意见，从而有助于改善口腔保健服务的提供。 会议信息将发布在DHCS Medi-Cal Dental 洛杉矶利益相关者会议网页上。 附加材料将在会议之前或可用时立即发布在网页上。 请将您的问题通过电子邮件发送至dental@dhcs.ca.gov 。
利益相关者咨询委员会 (SAC)/行为健康 (BH)-SAC 会议
On May 29, from 9:30 a.m. to 3 p.m., DHCS will convene the SAC/BH-SAC hybrid meeting (advance registration required). The meeting will include an update on Proposition 1 implementation. SAC provides DHCS with valuable input on ongoing California Advancing and Innovating Medi-Cal (CalAIM) implementation efforts, as well as helps DHCS further its efforts to provide high-quality, equitable care.
BH-SAC is a broad-based body that disseminates information and receives coordinated input regarding DHCS behavioral health activities. It was created as part of the ongoing DHCS effort to integrate behavioral health with the rest of the health care system and incorporates existing groups that have advised DHCS on behavioral health topics.
CalAIM 管理的长期服务和支持 (MLTSS) 及双重集成工作组会议
On May 30 at 10 a.m., DHCS will host the CalAIM MLTSS and Duals Integration Workgroup virtual meeting (advance registration is required). The workgroup serves as a stakeholder collaboration hub for CalAIM MLTSS and integrated care for dual eligible members and allows stakeholders to provide feedback and share information about policy, operations, and strategy for upcoming changes to Medi-Cal and Medicare.
议程主题包括双重合格特殊需求计划 (D-SNP) 州医疗补助机构合同 (SMAC) 和政策指南的最新情况、双重合格成员的医疗保险登记数据、默认登记试点、2025 年医疗保险和医疗补助服务中心 (CMS) 医疗保险优势和 D 部分最终规则，以及针对双重合格成员的增强护理管理和社区支持的演示。
以前的工作组会议的背景材料、记录和视频记录以及有关该工作组的其他信息均发布在CalAIM MLTSS 和 Duals Integration 工作组网页上。 如有问题或意见，请发送电子邮件至 info@calduals.org 。