December 15, 2023 – Stakeholder News
热门新闻
管理式护理组织 (MCO) 税务联邦批准
今天，医疗保险和医疗补助服务中心 (CMS) 批准了 MCO 税联邦豁免，为 DHCS 在授权有效期内实施 MCO 税铺平了道路，但须遵守未来有关医疗保健相关税收的联邦要求的任何变化。
议会法案 119（2023 年法令第 13 章）授权从1年2023月 至31年2026年 12 月 征收 MCO 税。 据估计，MCO 税将在 3.75 年的纳税期内提供 194 亿美元的净非联邦资金。 根据拨款和联邦政府对适用支付和费率方法的批准，MCO 税收收入将用于支持 Medi-Cal 计划，包括但不限于有针对性的供应商费率提高和其他投资，以提高 Medi-Cal 成员的可及性、质量和公平性，并促进供应商参与 Medi-Cal 计划。
根据州法律，DHCS 将在收到联邦批准的日期以书面形式证明，并向每个应纳税的 MCO 发出通知，概述每个纳税期应缴纳的税款以及分期付款税款的到期日期。 此外，DHCS 将在其网站上发布与 MCO 税相关的信息，包括批准信、每个纳税期应缴纳的税额以及其他相关信息。 在未来的利益相关者更新中将提供这些资源位置的链接。
更新的长期服务和支持 (LTSS) 数据仪表板
DHCS today released an updated LTSS data dashboard that features additional measures and improves data transparency and accessibility. As the state drives significant improvements in quality and health equity for Medi-Cal members, the LTSS data dashboard reports utilization and demographic data of long-term services and supports provided by counties and Medi-Cal managed care plans (MCP). It will allow users to explore trends across services and subpopulations throughout California.
The new December 2023 LTSS data dashboard includes data from 2017 through 2022 and features 16 additional utilization measures for home health services, the California Community Transitions project, and services utilized by Californians with developmental disabilities. The LTSS data dashboard will be updated biannually, future iterations will include additional cost and quality measures, and data will demonstrate progress toward “rebalancing” LTSS away from institutional care toward home and community-based services.
项目更新
DHCS 2023 Legislative Summary Report
DHCS today released the 2023 Legislative Summary report. This report provides a summary of chaptered and vetoed legislation for all significant bills the Department analyzed and engaged with during the first year of the 2023-2024 legislative session. Please note, this report does not represent a complete listing of bills the Department followed, nor any bills that did not make it to the Governor’s desk.
年龄 26-49 成人 F 全面实施 Medi-Cal 扩展计划
年 12 月11 2023 ，DHCS 向财政部提供了系统准备就绪证明，以实施“26-49 岁成人扩展计划”。 26-49 岁成人扩展计划将为 26-49 岁的个人提供全方位的 Medi-Cal 福利，无论其移民身份如何，只要他们符合所有其他 Medi-Cal 资格标准。 DHCS 将从 1 月1和2024起，完成将 26-49 岁成人扩展计划中限制范围 Medi-Cal 的个人过渡到全面范围 Medi-Cal。 已向受影响的个人发送了行动通知，告知他们从 1 月1 、 2024开始过渡到全范围的 Medi-Cal。
有关 26-49 岁成人扩展的更多信息，请访问26-49 岁成人扩展网页。 如对 26-49 岁成人扩展计划有疑问，请发送电子邮件至 AdultExpansion@dhcs.ca.gov 。
家庭和社区替代计划 (HCBA) 豁免名额增加修正案获批
On December 11, the federal Centers for Medicare & Medicaid Services (CMS) approved DHCS’ amendment to the HCBA Waiver adding slot capacity to the waiver for waiver years two through five (2024 – 2027). The waiver amendment approval is effective January 1, 2024, coinciding with the start of waiver year two (January 1, 2024 – December 31, 2024). The approved waiver amendment adds 1,800 additional waiver slots for each of the remaining four waiver years for a total increase in waiver capacity of 7,200 slots during the course of the waiver term. For additional information, including the approved waiver, visit the HCBA waiver webpage.
首页 提供访问和转型健康 (PATH) 能力和基础设施转型、扩展和发展 (CITED) 第三轮申请大纲将于 12 月 18 日发布
On December 18, 2023, DHCS will publish the PATH CITED Round 3 application outline to help prospective applicants prepare the resources and information required to complete their application prior to the opening of the funding window on January 15, 2023. The CITED Round 3 application window is expected to open on the PATH CITED website for 30 days, from January 15 through February 15, 2024. The application outline is intended to be used as a planning tool and intended to “preview” the application. It is not the formal application. Applicants are still required to apply for CITED Round 3 funding using the application link on the PATH CITED website.
The PATH CITED initiative provides funding to enable the transition, expansion, and development of Enhanced Care Management (ECM) and Community Supports capacity and infrastructure. Round 3 eligible entities include community-based organizations; county, city, or local government agencies; federally qualified health centers; Medi-Cal Tribal and Designee of Indian Health Program; providers; and others as approved by DHCS. Visit the PATH CITED website to learn more.
Medi-Cal 续保更新
DHCS 今天在Medi-Cal 注册和续订数据网页上发布了 2023 年 10 月 Medi-Cal 持续覆盖解除资格措施数据。 十月份的仪表板包括有关 Medi-Cal 注册、正在进行的申请、重新确定和取消注册的数据。 数据还包括所有重新确定措施的人口统计详细信息，以及取消注册的主要原因。
加入我们的团队
DHCS 正在招聘。 DHCS 提供以下机会：
- Assistant Deputy Director for Program Operations assists in leading, planning, organizing, and directing Program Operations, which is comprised of the California Medicaid Management Information System – Operations, Clinical Assurance, Provider Enrollment, and Third-Party Liability and Recovery Divisions. (Final filing date (FFD) is December 29)
- Chief of Capitated Rates Development within Health Care Financing serves as the principal policymaker for all rate-setting activities to ensure high-quality and cost-efficient health care through DHCS’ contracted Medi-Cal MCPs. (FFD is December 19)
- 医疗保健融资部门按服务收费费率开发主管负责制定、解释和发布 Medi-Cal 按服务收费 (FFS) 非机构和长期护理服务以及提供者费用计划的 Medi-Cal 报销方法政策。 （FFD）是12月20日）
DHCS 还在招聘人力资源、审计、卫生政策、信息技术和其他团队的人才。 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
增强护理管理 (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 更新了该指南，以提高全州数据标准化水平并减轻行政负担。
具体来说，DHCS 增加了新的 ECM 和社区支持 HCPS 代码/修饰符组合，并规定 MCP 不得要求或允许其医疗服务提供者报告超出 DHCS 在指南中定义的 ECM 和社区支持服务代码或修饰符。本次网络研讨会将为 MCP、ECM 和社区支持服务提供者以及其他感兴趣的利益相关者提供机会，了解有关 ECM 和社区支持 HCPS 编码指南更新的更多信息并提出问题。
远程医疗利益相关方顾问小组信息网络研讨会
12 月 19 日上午 10 点至 11 点，DHCS 将为远程医疗利益相关者咨询小组举办一次信息网络研讨会，并就 DHCS 正在最终确定的 Medi-Cal 提供商手册：与患者对远程医疗方式的选择和面对面服务的权利相关的远程医疗的更新内容征求反馈。 DHCS 预计这些更新将于 2024 年春季发布。 这些更新符合参议院第 184 号法案（2022 年法令第 47 章）和议会第 1241 号法案（2023 年法令第 172 章）中规定的要求。 网络研讨会结束后，DHCS 将为顾问小组成员提供三周的评论期。 请通过电子邮件将您的问题和公开意见提交至Medi-Cal_telehealth@dhcs.ca.gov。{cph0
Medi-Cal 费率增加网络研讨会
12 月 19 日，DHCS 将举行网络研讨会，与医疗服务提供者分享有关 Medi-Cal 费率上调的方式和时间的信息，该费率将于 1 月1 ，2024 ，将在 Medi-Cal FFS 和管理性护理服务系统中实施。12 月 1 日，DHCS 在DHCS 网站上公布了新的 FFS 费率。
根据《福利与机构法》第 14105.201 条、在获得联邦批准的情况下，DHCS 将把目标手术代码的 FFS 费率提高到不低于适用的 Medicare 费率的 87.5%。DHCS 将指示 Medi-Cal MCP 确保其向网络医疗服务提供者支付的目标程序代码费用不低于新的 FFS 补偿水平。受影响的服务是初级保健服务，包括由医生和非医生专业人员提供的服务、产科和助产士服务，以及非专科精神健康服务。
2023 年 8 月，DHCS 就目标程序代码列表和 FFS 费率增长方法征求公众意见，并于 9 月向 CMS 提交了州计划修正案 23-0035。此外，DHCS 还与一个 MCP 工作组密切合作，制定如何在管理性医疗服务系统中实施新的支付预期（定向支付安排）。由于多方保健计划需要更新其系统和医疗服务提供者合同，管理性医疗服务系统不会立即支付增加的费率。DHCS 将通过书面指导，正式确定 MCP 的合规时限，以便在适用的情况下，前瞻性地以及追溯到 1 月1 ，2024 ，全面执行增加的支付水平。
如需了解有关网络研讨会的更多信息，或有任何问题或意见，请发送电子邮件至TargetedRateIncreases@dhcs.ca.gov。
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（需要提前注册），与服务提供商分享信息，帮助儿科患者及其家人最大限度地享受 HACCP 带来的好处。 培训课程将讨论家庭申请保险的计划要求以及听力学家、耳鼻喉科医生、医生及其办公室工作人员的索赔提交流程。 欲了解更多信息，请访问www.dhcs.ca.gov/haccp 。
如果你错过了
加州推出新的阿片类药物资源网站
California launched a new, comprehensive opioid website that gives Californians a single resource for prevention, data, treatment, and support information. The website, OPIOIDS.CA.GOV, is part of Governor Newsom’s multi-pronged approach to connect Californians with information to prevent and reduce overdoses and deaths and support those struggling with substance use and addiction.
All Californians should visit OPIOIDS.CA.GOV to learn more and help us spread awareness and save lives. Together we can make a difference in combating this crisis.
We are also interested in hearing feedback from our partners about this new resource as we continue to iterate and improve the website. Please share your thoughts or comments with us at CommsOutreach@cdph.ca.gov.
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 transitioning to a new MCP received 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.