Dear Stakeholders,

The Department of Health Care Services (DHCS) is providing this update of significant developments regarding DHCS programs.​​ 

牙科合同授予​​ 

On July 1, 2022, DHCS issued a Notice of Intent to Award for the Fiscal Intermediary-Dental Business Operations (FI-DBO) contract, which will provide services to support California’s Medi-Cal fee-for-service dental benefit. Following a competitive procurement process, the successful bidder is Gainwell Technologies LLC.

Over the next year, the incumbent vendor, Delta Dental of California, will transition operations to the new vendor, Gainwell. The anticipated date for Gainwell to assume responsibility for dental business operations is October 1, 2023. DHCS’ goal is for this transition to be seamless for Medi-Cal members and providers, with no reduction in or delay of services.​​ 

56 号提案贷款偿还计划 - CalHealthCares​​ 

DHCS announced its commitment to pay $64.9 million toward student loans for 222 physicians and 35 dentists under CalHealthCares to expand access to care for Medi-Cal patients under a fourth cohort of awardees. Of the 257 awardees, 62 percent are persons of color, and 79 percent speak a language other than English. The physicians represent 67 specialties and serve 33 counties. The dentists represent four specialties and serve 19 counties. The awardees have agreed to maintain a caseload of at least 30 percent Medi-Cal patients, with more than 57 percent of awardees committing to maintaining a caseload of 65 percent or higher. A fifth cohort is scheduled for 2023. For more information, visit the CalHealthCares website.​​ 

增强护理管理 (ECM) 和社区支持福利更新​​ 

从 7 月 1 日开始，加州所有县的符合条件的 Medi-Cal 管理式医疗计划 (MCP) 成员均可享受 ECM 福利，重点关注以下人群：无家可归的个人和家庭、高使用率者以及患有严重精神疾病 (SMI) / 物质使用障碍 (SUD) 的成年人。 截至 7 月 1 日新实施 ECM 的县包括 Alpine、Amador、Butte、Calaveras、Colusa、Del Norte、El Dorado、Fresno、Glenn、Humboldt、Inyo、Lake、Lassen、Madera、Mariposa、Merced、Modoc、Mono、Nevada、Plumas、San Benito、San Luis Obispo、Santa Barbara、Sierra、Siskiyou、Solano、Stanislaus、Sutter、 Tehama、Trinity、Tuolumne、Yolo 和 Yuba。​​ 

此外，截至 7 月 1 日，MCP 将实施另外 266 项社区支持，将这些独特服务的可用性扩展到加州所有 58 个县。重大服务扩展包括与住房相关的社区支持服务，其中 MCP 引入了 35 项新的住房过渡导航服务、44 项新的住房押金、36 项新的住房租赁和维持服务，以及临时照护服务（34 项新产品）和个人护理及家政服务（31 项新产品）。自 1 月 1 日首次实施计划以来，已经提供了 518 项社区支持，现在加州所有 58 个县共有 784 种不同的社区支持服务。DHCS 创建了一个公开的社区支持地图，按县和实施日期显示了 2022 年上线的 14 个预先批准的社区支持的数量。还提供了社区支持选举图表，详细说明了每个县的每个 MCP 下可用的服务，并预测了未来预期的服务内容。​​  

社区卫生工作者 (CHW) 福利​​ 

On July 1, the CHW benefit went live in both the Medi-Cal fee-for-service (FFS) and managed care delivery systems. The State Plan Amendment (SPA) for CHWs was submitted to the Centers for Medicare & Medicaid Services (CMS) on April 29, 2022, and is pending approval. DHCS published the final CHW policy on June 29 to assist providers with rolling out this new benefit. DHCS shared a draft of the Provider Manual pages for CHW services, as well as a new Provider Manual section for asthma preventive services, with stakeholders prior to finalizing them for publication. The Provider Manual pages are scheduled to be published on July 15. In addition, DHCS shared a draft All Plan Letter (APL) for CHW services with its managed care health plan partners on June 28 for comments prior to issuing the APL. Comments on the APL are due by July 12. More information about the Department’s development of the CHW benefit, including the pending SPA that was submitted to CMS, is available on CHW webpage.

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