热门新闻​​ 

获准参与 CYBHI 多付款人费用计划的地方教育机构 (LEA)​​ 

On December 1, DHCS announced the first cohort of 47 LEAs (across 25 counties) approved to participate in the Children and Youth Behavioral Health Initiative (CYBHI) statewide multi-payer school-linked fee schedule, which will launch in January 2024, and statewide provider network. As part of the CYBHI, DHCS is expanding access to school-based (or school-linked) behavioral health services provided to students at a school site. Specifically, DHCS, in collaboration with the Department of Managed Health Care and California Department of Insurance, is establishing a statewide multi-payer school-linked fee schedule to reimburse school-linked providers for the provision of specified outpatient mental health and substance use disorder services furnished to students 25 years of age or younger at a school site. A fee schedule establishes a scope of services (e.g., psychoeducation, screening/assessment, treatment, and care coordination services), identifies billing codes and rates, and specifies provider types eligible to bill for services. Under state law, Medi-Cal managed care plans (MCP), commercial health plans, and disability insurers are obligated to reimburse eligible school-linked providers, including LEAs (e.g., services performed by pupil personnel services credentialed practitioners) and school-linked affiliated community-based organizations.​​ 

Welfare and Institutions Code section 5961.4(b) authorizes DHCS to “develop and maintain a school-linked statewide provider network of school-site behavioral health counselors.” To develop the CYBHI fee schedule provider network, DHCS implemented an operational readiness review process for all interested county offices of education and LEAs. In determining LEA readiness for this cohort, DHCS considered a variety of factors, including, but not limited to, Medi-Cal enrollment, service delivery infrastructure and capacity building, data collection and documentation, and billing infrastructure. The 47 LEAs met readiness review requirements and will participate in a learning collaborative to inform state level policy and operational guidance for the CYBHI fee schedule program. Cohort 2 will launch in July 2024 and Cohort 3 in January 2025.​​ 

More information about the CYBHI fee schedule program is available on the Statewide Multi-Payer School-Linked Fee Schedule webpage.​​ 

 

加入我们的团队​​ 

DHCS 正在招聘。 DHCS 提供以下机会：​​ 

• Chief of Fee-for-Service Rates Development within Health Care Financing to develop, interpret, and issue policy on Medi-Cal reimbursement methodologies for Medi-Cal fee-for-service non-institutional and long-term care services and provider fee programs, ensuring uniform application of federal and state laws and regulations. (Final filing date (FFD) is December 20)​​ 
• Chief of Capitated Rates Development within Health Care Financing to serve as the principal policymaker for all rate-setting activities to ensure high-quality and cost-efficient health care through DHCS’ contracted Medi-Cal managed care plans. (FFD is December 19)​​ 
• Deputy Director of Enterprise Technology Services and Chief Information Officer to lead and manage Department-wide IT services. Responsible for managing all IT services, information security, enterprise projects, and strategic innovation efforts. (FFD is December 8)​​ 
• Deputy Chief Counsel in the Office of Legal Services to provide advice and counsel to the directorate, deputy director and chief counsel, and other deputy directors on legal policy litigation, federal policy, financial operations, and legislation. (FFD is December 4)​​  

DHCS is also hiring for our human resources, auditing, health policy, and information technology teams. 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​​ 

Medi-Cal 成人扩展网络研讨会​​ 

12 月 4 日上午 11 时至中午 12 时，DHCS 将为社区组织、MCP、医疗服务提供者和其他感兴趣的利益相关者（包括代表消费者、医疗保健、法律援助和成年移民的利益相关者）举办一次有关 Medi-Cal 成人扩展的网络研讨会（需提前注册）。DHCS 将根据参议院第 184 号法案（第 47 章，2022 年法规）于1,2024 实施这一扩展。扩展计划实施后，26-49 岁的成年人，只要符合 Medi-Cal 的所有其他资格标准，无论其公民身份或移民身份如何，都可享受 Medi-Cal 的全面福利。​​ 

The webinar, which will be live and interpreted in Spanish, will provide background information about the expansion, implementation planning, noticing, outreach, and more. Individuals may also submit questions or request to register for the webinar by sending an email to AdultExpansion@dhcs.ca.gov.​​ 

提供机会和转型健康 (PATH) 司法相关计划办公时间​​ 

12 月 4 日中午 12 点，DHCS 将为第 3 轮获奖者举办下一次 PATH 司法参与计划虚拟办公时间会议（需提前注册）。办公时间为每隔一周的周一中午 12 点至 12 月18 ，2023 ，以协助第 3 轮机构，包括支持实施计划的提交。如需了解更多信息，请访问参与司法计划网站。​​   

计划生育网络研讨会中的创伤调查和应对​​ 

12 月 7 日中午 12:00 至下午 1:30，DHCS 和加州预防中心将举办计划生育中的创伤调查与应对网络研讨会（需提前注册）。创伤，包括不良童年经历、人际暴力和性侵犯，对健康结果有重大影响，在寻求计划生育服务的人群中很常见。心理创伤会影响性健康和生殖健康、怀孕和心理健康，因此临床医生在提供计划生育服务时必须处理心理创伤问题。​​ 

该网络研讨会将讨论创伤和复原力知情探究逆境、痛苦和优势 (TRIADS) 框架及其对计划生育临床医生的帮助方式。 通过案例研究，演讲者将描述 TRIADS 框架如何建立同理心、尊重和同情的基础，从而提高护理参与度并改善寻求计划生育服务的患者的健康状况。​​ 

For those unable to attend the live webinar, a transcript and recording of the webinar, along with additional resources, will be available on the Family PACT website at a later date.​​ 

PATH 协作规划与实施 (CPI) 最佳实践网络研讨会​​ 

On December 7, from 12:30 to 1:30 p.m., DHCS will host a statewide webinar, Relationship Building with Organizations in the California Advancing and Innovating Medi-Cal (CalAIM) Environment (advance registration required) for community-based organizations, county, city, and local government agencies, federally qualified health centers, MCPs, Medi-Cal tribal and designees of Indian Health Programs, and providers. The webinar is part of a biannual series of PATH CPI webinars designed to highlight best practices for implementing Enhanced Care Management (ECM) and Community Supports, increasing providers’ successful participation in CalAIM, and improving collaboration with MCPs, state and local government agencies, and others to build and deliver quality support services to Medi-Cal members. For more information, please visit the PATH CPI webpage.​​ 

指导改善痴呆症体验 (GUIDE) 模型网络研讨会​​ 

On December 8, from 11 a.m. to 12 p.m., DHCS, in partnership with the University of California, San Francisco and DHCS’ Dementia Care Aware initiative, will host a webinar on the GUIDE model in California (advance registration required). This webinar will offer Medicare providers and community-based organizations information about what is required to participate in GUIDE, examples of a successful partnership in California that follows the GUIDE model, and resources to help California applicants apply for the GUIDE model. For more information, please visit the Dementia Care Aware webpage.​​ 

CalAIM 人口健康管理 (PHM) 咨询小组会议​​ 

On December 11, from 10:30 a.m. to 12 p.m., DHCS will host a PHM Advisory Group meeting (advance registration required). This meeting will include a briefing on policy guidance for changes to the modified Population Needs Assessment (PNA). To support the success of the PHM Program and broader transformation efforts, DHCS is redesigning MCP requirements for developing a PNA, which has historically been MCPs’ primary mechanism for identifying the priority health and social needs of their members, including health disparities. A central component of DHCS’ approach is for MCPs to meaningfully participate on local health departments’ Community Health Assessments (LHD CHA)/Community Health Improvement Plans (CHIP) rather than complete a separate PNA focused solely on their own members’ data. This meeting will provide an overview of forthcoming PHM policy guidance for MCPs to participate in LHD CHA/CHIP processes.​​ 

DHCS established the PHM Advisory Group to provide input to support the design and implementation of the PHM Program and PHM Service. Members, which include representatives from health plans, providers, counties, state departments, consumer organizations, and other groups, will participate in advisory group meetings and provide real-time feedback and recommendations. The meetings are open to the public, and meeting information and materials will be available on the DHCS website. Stakeholders are encouraged to submit questions in advance of the webinar to PHMSection@dhcs.ca.gov.​​ 

CalAIM LTC 豁免：Medi-Cal 管理式护理如何支持亚急性护理机构和 ICF/DD 养老院居民网络研讨会​​ 

12 月 15 日，DHCS 将以虚拟方式举办一次有关 CalAIM 长期护理（LTC）分割的教育网络研讨会（需提前注册）。本次网络研讨会的目的是让亚急 性护理机构、发育障碍人士中级护理机构 (ICF/DD) 之家、地区中心和 Medi-Cal MCP 了解管理式护理下的政策要求、服务范围以及亚急性护理机构和 ICF/DD 之家居民可享受的福利，为 1 月1,2024 的分割做准备。有关网络研讨会和 "分割 "的更多详细信息，请访问 CalAIM LTC "分割 "过渡网页。​​  

ECM 和社区支持医疗保健通用程序编码系统 (HCPCS) 编码指导网络研讨会​​ 

12 月 18 日上午 11 时至中午 12 时，DHCS 将举办网络研讨会，概述 ECM 和社区支持 HCPCS 编码指南的最新更新（需提前注册）。DHCS 最初于 2021 年发布了指南，其中包括在报告和结算 ECM 和社区支持服务时必须使用的 HCPCS 代码和修饰符。这包括 ECM 和社区支持服务提供者提交给 MCPs 用于索赔或开具发票的遭遇数据，以及 MCPs 提交给 DHCS 用于监控计划绩效和完整性的遭遇数据。根据利益相关者在 ECM 和社区支持实施初期提交的反馈意见，DHCS 更新了本指南，以提高全州数据标准化水平，减轻行政负担。​​ 

具体而言，DHCS 增加了新的 ECM 和社区支持 HCPCS 代码/修饰符组合，并编纂了以下要求：MCP 不得要求或允许其提供商报告超出 DHCS 在指南中定义的 ECM 和社区支持服务的代码或修饰符。 该网络研讨会将为 MCP、ECM 和社区支持提供商以及其他感兴趣的利益相关者提供了解更多信息和询问有关 ECM 和社区支持 HCPCS 编码指南更新的问题的机会。​​ 

面向医疗服务提供者和听力专业人士的儿童助听器覆盖计划 (HACCP) 网络研讨会​​ 

12 月 19 日中午 12 点至下午 1 点，DHCS 将举办 HACCP 网络研讨会（需提前注册），与医疗服务提供者分享信息，帮助儿科患者及其家属最大限度地享受 HACCP 福利。培训课程将涉及家庭申请保险的计划要求，以及听力学家、耳鼻喉学家、医生及其办公室工作人员的索赔提交流程。如需了解更多信息，请访问 www.dhcs.ca.gov/haccp。​​ 

如果你错过了​​ 

2024 年 1 月 Medi-Cal MCP 过渡期​​ 

As part of Medi-Cal transformation, some MCPs are changing on January 1, 2024, and approximately 1.2 million members will have new health plan options and/or will need to transition to new MCPs. Changing MCPs will not affect Medi-Cal member coverage or benefits. Members who transition to a new MCP are receiving notices about the transition. DHCS developed several resources to support members, providers, and other stakeholders with the transition, including the Managed Care Plan Transition Member webpage with a county “lookup” tool, links to member notices sent by Medi-Cal about MCP changes, frequently asked questions, and a Contact Us page for members to learn more about health plans and provider choices. There are also transition resources for providers and MCPs and stakeholders. More information about the transition is available in the 2024 Managed Care Plan Transition Policy Guide and Medi-Cal Eligibility Division Information Letter Number I 23-54.
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