DHCS 利益相关者更新 - 8 月25 、 2023
热门新闻
CalAIM 示范修正案批准
On August 23, the Centers for Medicare & Medicaid Services (CMS) approved an amendment to the California Advancing and Innovating Medi-Cal (CalAIM) Section 1115 demonstration waiver, allowing the state to implement county-based model changes in its Medi-Cal managed care program. The amendment includes expenditure authority to limit the choice of managed care plans (MCPs) in non-rural areas. This authority would apply in the metro, large metro, and urban counties intending to participate in the County Organized Health System (COHS) or Single Plan models.
For rural counties, CMS approved an amendment to the CalAIM Section 1915(b) waiver on June 26 to limit plan choice in rural counties to participate either in the COHS or Single Plan models. These county-based model changes will go into effect on January 1, 2024. Twelve counties will become COHS and three will become Single Plan model counties. For more information about all counties, their current and 2024 model type, and the MCPs operating in the county, please see the MCP county table.
项目更新
医疗补助计划
8 月 22 日，加州医疗保险处方药客户服务中心为会员、处方医生、药剂师和公众推出了交互式语音识别增强功能。增强功能包括呼叫调查、简化呼叫的主菜单、告知座席人员呼叫原因的代码、循环返回主菜单以便呼叫者检查多个自助服务项目，以及改进提示语言和位置。
On August 16, a New Start PA Reminder Alert was published about the prior authorization requirements that will be reinstated beginning on September 22 for new start enteral nutrition products for members 22 years of age and older.
儿童医疗保险& 青少年信息邮件
On August 25, DHCS distributed an informational mailing to Medi-Cal fee-for-service (FFS) members and/or their parents or guardians about the federal Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services, known in California as Medi-Cal for Kids & Teens. The FFS mailing includes: (1) Medi-Cal for Kids & Teens brochures to improve member understanding of how Medi-Cal works for children, teens, and young adults, what it covers, and its role in preventive care screening, diagnosis, and treatment. The child brochure is for children up to age 12, and the teen brochure is for ages 12-20; and (2) “Medi-Cal for Kids & Teens: Your Medi-Cal Rights” guide to help members under age 21 understand their Medi-Cal benefits and their recourse if medically necessary care is denied, delayed, reduced, or stopped. The materials, including translations, are posted on the Medi-Cal for Kids & Teens webpage.
加入我们的团队
DHCS 正在招聘财务、人力资源、法律、审计、卫生政策和信息技术团队的人员。 欲了解更多信息，请访问CalCareers 网站。
DHCS is dedicated to providing equitable access to quality health care, leading to a healthy California for all. DHCS’ goals and objectives express the tremendous work DHCS is leading to transform our health care system and reflect the organizational culture we are building together.
即将举行的利益相关方会议和网络研讨会
将创伤知情实践融入生殖健康服务网络研讨会
8 月 30 日中午 12:00 至下午 1:30，DHCS 和加州预防培训中心（California Prevention Training Center）将举办 "生殖健康服务中的创伤知情实践整合 "网络研讨会。创伤知情护理承认需要了解客户的生活经历才能提供有效的护理，并有可能提高患者的参与度、治疗依从性和健康结果。对于无法参加现场网络研讨会的人员，将在Family PACT 网站上提供网络研讨会的文字记录和录音，以及其他资源。
部落和印第安人健康计划指定人员季度网络研讨会
On August 30, from 2 to 3 p.m., DHCS will host a webinar (advance registration required) for tribal and Indian health program representatives to provide feedback on DHCS initiatives with specific impact to tribes, Indian health programs, and American Indian Medi-Cal members. The webinar will provide information about State Plan Amendments, waivers, and demonstrations proposed for submission to CMS, including the Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) Medicaid section 1115 demonstration and transitional rent services amendment to the CalAIM section 1115 demonstration. Email questions or comments to TribalAffairs@dhcs.ca.gov.
公平与实践转型支付计划网络研讨会
On August 30, from 3 to 4 p.m., DHCS will host an Equity and Practice Transformation Payments Program Webinar (advance registration required) to share an update on the Equity and Practice Transformation Payments Program, which is a one-time $700 million primary care practice transformation program initiative to advance health equity and population health and invest in upstream care models. Details about the Provider Directed Payment Program will be discussed during the webinar; the program application and other materials will be posted on the DHCS website in the future. Please email ept@dhcs.ca.gov with any questions.
DHCS 覆盖大使：培训师网络研讨会
On August 31, from 10 to 11:30 a.m., DHCS will host a webinar on Coverage Ambassadors: Train the Trainer. The webinar will serve as a training session for Coverage Ambassadors to better assist their communities as California resumes standard Medi-Cal operations and communicates the importance of members renewing their Medi-Cal coverage. The webinar will also describe the resources available and how to use them. For more information, visit the Coverage Ambassadors Coverage Ambassadors webpage. Join the Coverage Ambassadors mailing list to receive the latest information and updated toolkits as they become available.
护理机构融资改革网络研讨会
On September 7, from 2 to 3 p.m., DHCS will host a virtual stakeholder webinar to discuss the development of the Skilled Nursing Facility Workforce Standards Program and provide updates on other nursing facility financing reform programs authorized by Assembly Bill 186 (Chapter 46, Statutes of 2022). Stakeholder input will be accepted. Additional information is available on the Nursing Facility Financing Reform (AB 186) webpage.
面向家庭和社区伙伴的儿童助听器覆盖计划 (HACCP) 网络研讨会
On September 12, from 11 a.m. to 12 p.m., DHCS will host a HACCP webinar to share guidance with families and communities about applying for hearing aid coverage and helping children to maximizing their HACCP benefits once enrolled. DHCS welcomes newly interested families, those who are currently participating in HACCP, and community partners supporting families and children to join this webinar for program updates, tips, and a Q&A session. For more information, please visit www.dhcs.ca.gov/haccp.
导乐实施工作组会议
9 月 14 日中午 12 点至下午 2 点，DHCS 将举办第三次 Doula 实施工作组会议。会议的收听链接将于 8 月 31 日前发布在作为 Medi-Cal 福利的 Doula 服务网页上。会议将包括关于 DHCS 的分娩护理路径建议和朵拉的作用的报告，以及未来会议的计划。该工作组负责审查如何通过教育推广计划增加朵拉服务的可用性，识别并最大限度地减少朵拉服务的障碍，以及解决向朵拉和会员付款和报销延迟的问题。
面向医疗服务提供者和听力专业人士的网络研讨会
On September 14, from 12 to 1 p.m., DHCS will host a HACCP webinar to share information with providers to help pediatric patients and their families maximize HACCP benefits. The training session will address program requirements for families to apply for coverage and the claims submission process for audiologists, otolaryngologists, physicians, and their office staff. For more information, please visit www.dhcs.ca.gov/haccp.
如果你错过了
加州扩大监狱和毒品法庭提供阿片类药物治疗的机会
On August 22, DHCS announced it will expand Medication Assisted Treatment (MAT) to jails and drug courts it will expand Medication Assisted Treatment (MAT) to jails and drug courts. The $2.9 million in funding will go to 29 counties to support the development or expansion of access to MAT. By bringing county teams together in a learning collaborative, county agencies and providers serving justice-involved residents can more effectively coordinate and further build system capacity to ensure access to effective treatment and recovery supports. This expansion will better serve residents in need, and MAT, specifically, has been shown to reduce criminal activity and reincarceration to better serve the entire community.
纽约州延长 CalHOPE 学校计划合作伙伴关系
On August 24, DHCS announced the extension of the CalHOPE Schools Initiative through June 30, 2024 the extension of the CalHOPE Schools Initiative through June 30, 2024. The initiative provides free resources for school personnel, youth, and parents surrounding three powerful films that address student social-emotional and mental health needs: A Trusted Space: Redirecting Grief to Growth, Angst: Building Resilience, and Stories of Hope Shorts.
国会周刊关于 Medi-Cal 重新裁定的意见
8 月 20 日，《国会周刊》刊登了洛杉矶关怀组织首席执行官约翰-巴克斯（John Baackes）的一篇评论文章。LA Care 是洛杉矶县的 Medi-Cal 管理性护理计划之一。Baackes 呼吁 "我们所有人--邻居、政府合作伙伴和社区倡导者--尽我们所能让我们的朋友和邻居获得 Medi-Cal 保险"。
当您与 Medi-Cal 会员交流时，请与他们分享保持其保险的有用提示。如果他们的资格更新日期在 6 月或 7 月，现在还不算太晚。他们可以在今天将 Medi-Cal 续保资料交回当地县办事处，以便将保险恢复到原来的续保日期。此外，如果 Medi-Cal 会员在过去几年中搬家或联系方式发生变化，他们应确保当地县办事处有他们的最新信息，以便可以联系到他们并提供重要的续保信息。如果会员收到用黄色信封邮寄的 Medi-Cal 续保资料包，他们必须迅速采取行动，交回续保文件，使自己和家人继续享有保险。