DHCS Stakeholder News – July 29, 2022
卫生保健服务部 (DHCS) 正在提供有关 DHCS 计划重要进展的最新消息，以及与 COVID-19 公共卫生紧急情况 (PHE) 相关的指导。
热门新闻
关于每两个月一次的利益相关者更新的公告
DHCS 正在整合其利益相关者的更新，并将每周发布利益相关者新闻电子邮件，而不是每两个月发布一次更新。 这一变化将使利益相关者能够更频繁地收到更及时的新闻。
ACE 意识
意识到童年逆境（ACEs Aware）倡议发布了一份新的季度数据报告，详细介绍了 1 月1,2020, 和 9 月30,2021 期间为加州儿童和成人进行的童年逆境（ACE）筛查的数量。数据显示，加州医保临床医生（主要是儿科、家庭医学和行为健康专业人员）对超过 79.3 万名加州医保受益人进行了约 98.75 万次 ACE 筛查。
本报告还追踪了在 12 月4,2019 和 5 月31,2022 之间完成 "成为加州 ACE 意识 "在线培训的临床团队成员人数。 数据显示，超过 23,400 人参加了 ACE 意识培训，其中 11,900 人是获得 ACE 意识认证的 Medi-Cal 临床医生，他们有资格因开展 ACE 筛查而获得 Medi-Cal 支付。
行为健康连续基础设施计划 (BHCIP) 更新
DHCS 通过 2021 年立法授权建立 BHCIP，并拨款 21 亿美元用于建设、收购和扩建财产，以及投资与行为健康相关的移动危机基础设施。 为扩建行为健康设施，将分几轮发放资金，以下是即将到来的几轮资金的最新情况：
- BHCIP 第四轮：儿童和青年
Round 4 focuses on children and youth ages 25 and younger, including pregnant and postpartum people and their children, children, and transition-age youth, as well as their families. All applicants must demonstrate how their infrastructure project will expand behavioral health services for this population exclusively. DHCS will award $480.5 million for children- and youth-focused behavioral health infrastructure projects in this fourth round of competitive grants. The deadline to submit applications for the Request for Application (RFA) for Round 4: Children and Youth is August 31, 2022. Applicants will be expected to demonstrate “project readiness”, as detailed in the posted RFA, and will be funded according to which of three pre-construction phases their project is in. Full project funding will be contingent upon completion of all three phases of development planning.
- BHCIP 第五轮和第六轮：第五轮和第六轮目前正处于规划阶段。计划于 8 月 4 日下午 1 时至 2 时举行 "第 5 轮：危机连续性 "听证会，为符合条件的申请人提供一个直接向 DHCS 提供意见的机会，以便为 BHCIP 第 5 轮的规划和实施提供信息。第 5 轮聆听会议需要注册。有关 BHCIP 的更多信息，请访问 BHCIP 项目网站或发送电子邮件至BHCIP@dhcs.ca.gov。
牙科转型计划
On August 1, DHCS will begin issuing final Dental Transformation Initiative (DTI) payments for specific domains. The Budget Act of 2022 included $30.2 million to make DTI payments in fiscal year (FY) 2022-23 and $1.5 million in FY 2023-24. The DTI consisted of four domains to improve dental health for Medi-Cal children by focusing on high-value care, improved access, and utilization of performance measures to drive delivery system reform.
Domain 1 compensated service office locations with incentive payments for select preventive services if the provider increased enrolled Medi-Cal beneficiary utilization. Domain 2 allowed participating Medi-Cal Dental providers to receive payments for providing services to enrolled Medi-Cal beneficiaries, ages 6 and under, for a bundled service that included a caries risk assessment, treatment plan, nutritional counseling, and motivational interviewing. Domain 3 provided annual incentive payments to service office locations that maintained continuity of care for enrolled Medi-Cal beneficiaries. Dental managed care plans are not offered these incentive payments given the inherent requirement that managed care delivery systems provide continuity of care for their covered populations.
領域 1 和領域 2 的付款將支付給全州 Medi-Cal 牙科付費服務 (FFS) 提供系統中所有符合資格的 Medi-Cal 牙科服務提供者，包括符合資格的安全網診所（如聯邦合格醫療中心、農村醫療診所和印第安人醫療服務/協議備忘錄診所（社區醫療中心）），以及薩克拉門托縣和洛杉磯縣的牙科管理性護理提供系統。域 1 的付款将于 8 月 1 日那一周发放，域 2 的付款将于 8 月 8 日那一周发放。领域 3 "的付款也将在 8 月 1 日的一周内支付给 FFS 医疗服务提供者。
DHCS 预计本付款周期将是领域 1 和 2 的最后一个付款周期，另外的领域 3 付款将于 7 月3 ，2023 。7 月 29 日将在 Medi-Cal 牙科保健提供者公告网站上发布并公布一份特别提供者公告，以通知提供者。
Domain 4, Local Dental Pilot Projects (LDPP), addressed Domains 1-3 through local pilot programs aimed at specific demographics. The goals were to address one or more of the three domains through alternative programs and potentially use strategies focused on rural areas, including local case management initiatives and education partnerships. As of December 31, 2020, all 13 LDPPs concluded their operations and began their administrative closeout phase.
加强审查设置公众意见征询期
7 月 29 日，DHCS 公布了家庭和社区服务（HCBS）设置最终规则文件，以征求为期 30 天的公众意见。其中包括 115 家辅助生活和集中生活保健设施的汇总表，这些设施被 DHCS 确定为需要加强审查的对象，并随后被 DHCS 确定为符合《HCB 设置最终规则》的标准。
根据《危疾儿童收容机构最终规则》的要求，州政府必须确定哪些收容机构被认为具有机构性质。这些环境包括1) 提供住院治疗的公有或私有设施；2) 位于公共机构内或紧邻公共机构；或 3) 具有将接受 Medi-Cal 资助的 HCBS 服务的个人与更广泛的社区隔离的效果。只有在州政府确定该机构克服了机构推定的情况下，才会启动加强审查程序；因此，州政府向医疗保险& 医疗补助服务中心（CMS）提交的任何需要加强审查的机构，都是那些已证明其不属于机构性质的机构。
7 月 29 日至 8 月 28 日期间，公众可对每个设施环境的摘要表进行评论，该摘要表描述了该设施环境、需要加强审查的原因，以及支持 DHCS 认定该设施环境符合《HCB 设置最终规则》标准的现有证据。
提交公众意见的说明可在DHCS HCBS 全州过渡计划网页上查阅。DHCS 将收集这些信息并更新最终的全州过渡计划，以便在提交 CMS 之前再征求公众意见。DHCS 鼓励利益相关者继续访问网站了解更多信息，如有任何问题，请发送电子邮件至STP@dhcs.ca.gov。
猴痘更新：实验室计费
7 月26 ，2022 ，美国医学协会现行程序术语（CPT）编辑小组创建并发布了现行程序术语代码，以简化目前在美国可用的矫形痘病毒和猴痘检测报告，其中包括实验室检测代码：
- 87593：通过核酸（DNA 或 RNA）检测传染性病原体；正痘病毒（例如猴痘病毒、牛痘病毒、痘苗病毒），扩增探针技术，各一种。
This new code is currently not programmed for billing in FFS Medi-Cal. Medi-Cal will announce when the claims adjudication system is ready, and release additional instructions providers should use when billing for a monkeypox testing code. Until then, providers are advised to administer the test when medically indicated and hold the Medi-Cal claim submission until further notice.
目前，包括 Labcorp、Quest、Aegis、梅奥诊所实验室和 Sonic Healthcare 在内的几家大型商业实验室都在提供检测服务。 一些地方的公共卫生实验室也提供检测服务。 公共卫生检测不收费，商业检测应按上述规定收费。目前，联邦政府已向加州分配了数量有限的猴痘疫苗，加州公共卫生局 (CDPH) 正与当地卫生部门合作提供这些疫苗。
DHCS will continue to update and inform all Medi-Cal providers about testing and vaccinations related to monkeypox as guidance becomes available.
Both the CDPH and the Centers for Disease Control and Prevention websites provide further guidance on monkeypox symptoms, testing, treatment, and vaccination.
牙科服务提供商申请和注册验证 (PAVE) 门户
10 月 31 日，DHCS 将为牙科医疗服务提供者实施 PAVE 门户网站。PAVE 门户网站是一个基于网络的应用程序，旨在简化和加快注册流程。PAVE 将提供一种向 DHCS 提交牙医提供者注册申请和所需文件的新模式，允许申请人使用 Medi-Cal 提供者电子表格申请。一旦实施 PAVE，DHCS 将不再接受纸质申请。
Dental providers are invited to attend an online demonstration. The two-part series will begin with an introduction to PAVE on August 24, and an overview of key features to be scheduled for October. A more in-depth training session will be scheduled for November, following the implementation of PAVE. Each session is one hour. The demonstrations will be recorded and made accessible for future reference on the DHCS PAVE webpage. DHCS will release a Special Provider Bulletin by August 8 to notify providers about the upcoming trainings.
全州 HCBS 差距分析和多年路线图 – 承包商选择
2022 年 3 月，DHCS 发布了一份信息征集书 (RFI)，向有兴趣的各方征集信息，以协助 DHCS 启动一个重大项目，对加州的 HCBS 和 Medi-Cal 长期支持与服务管理 (MLTSS) 计划和网络进行全州范围的差距分析和多年期路线图。DHCS 收到了多个竞争性投标，并通过严格的筛选程序确定 Mathematica 最适合实现 "资金随人走"（MFP）补充资金--差距分析和多年期路线图的目标。DHCS 计划在 8 月份与 Mathematica 敲定合同/工作范围，承包商将在合同执行后立即开始工作。差距分析将于 9 月提交30,2023 ，多年期路线图将于 3 月提交31,2024 。DHCS 将在 6 月之前向利益相关者和立法者提交最终成果30 ，2024 。
已发布的 COVID-19 信息
即将举行的利益相关方会议和网络研讨会
CalAIM 网络研讨会和办公时间：增强护理管理 (ECM) 和社区支持计划数据交换概述
On August 4, from 10:30 a.m. to 12 p.m., DHCS will host a webinar on data exchange necessary for ECM and Community Supports, intended especially for managed care plans (MCPs) and providers in counties where ECM launched in July 2022, but open to all as a refresher. DHCS will provide an overview of the guidance documents that were released last year and corresponding data flows, with a focus on the exchange of information that occurs between MCPs and ECM and Community Supports providers. The webinar is for ECM and Community Supports Providers, MCPs, and others engaged in the implementation of ECM and Community Supports.
There will be time reserved during the webinar for participant questions and answers, as well as a follow-up office hours session for further questions on August 11, from 2 p.m. to 3 p.m. Advance registration is required for the ECM webinar and the office hours session. Please email CalAIMECMILOS@dhcs.ca.gov with any questions.
Medi-Cal 消费者利益相关方工作组 (CFSW) 会议
8 月 5 日，健康与社会服务部将通过网络研讨会召开下一次社区卫生服务委员会会议。有关工作组的更多信息，请访问粮安委网页。如有任何问题，请发送电子邮件至DHCSCFSW@dhcs.ca.gov。