项目更新​​ 

更新的增强护理管理 (ECM) 和社区支持数据​​ 

1 月 29 日，DHCS 将公布来自 Medi-Cal 管理性护理计划 (MCP) 的新 ECM 和社区支持数据。新报告提供了一份更新的互动报告，通过提供截至 2023 年第 2 季度的详细州、县和多指标类集项目一级的数据，加强了 2022 年的实施报告。下一次季度更新将包括 2023 年第 3 季度的实施数据，计划于 2024 年第 1 季度末发布。​​ 

Medi-Cal 续保活动更新​​ 

In early February, DHCS will refresh messaging for the Medi-Cal renewal campaign. New ads will prepare people for the return of annual Medi-Cal renewals. The ads will run on digital, television, radio, print, and out-of-home platforms. The content will be distributed through existing partnerships with Univision and Telemundo for Spanish-language television and a new partnership with CrossingsTV for Mandarin, Cantonese, Vietnamese, Punjabi, Korean, and Hmong programming. Select videos will also be updated to include voiceovers to increase accessibility and exposure to more audiences, such as the visually impaired and those who cannot read. Voiceover videos will be available in all threshold languages. New awareness and renewal outreach materials will be available on the Keep Your Community Covered resources hub for download and sharing in all 19 threshold languages.​​ 

DHCS 还利用可用数据重新定位续订率较低的社区，特别是由于成员未提供所需的文件或信息而导致取消注册率较高的社区。​​ 

儿童和青少年行为健康计划 (CYBHI) 费用表指南​​ 

1 月 25 日，DHCS 发布了CYBHI 费用表指导草案，征求公众意见。 该指导文件草案概述了通过全州多付款人学校相关费用表（CYBHI 费用表）扩大学校相关行为健康服务覆盖面的初步政策和程序，并包括对地方教育机构、指定从业者、Medi-Cal MCP 和其他保险公司的指导。​​ 

DHCS is accepting feedback and public comment until February 7 at 5 p.m. Feedback and questions can be submitted to DHCS.SBS@dhcs.ca.gov. For more information, please visit the CYBHI webpage.​​ 

综合围产期服务计划 (CPSP) 服务计费扩展​​ 

2 月 1 日，DHCS 将实施必要的系统变更，以允许在加州公共卫生部 (CDPH) 注册为 CPSP 提供者的持照助产士为 Medi-Cal 按服务收费 (FFS) 会员提供的 CPSP 服务开具账单。 如果您对通过 CDPH 进行 CPSP 注册有任何疑问，请发送电子邮件至 CPSPProviderEnrollment@cdph.ca.gov 。​​ 

加入我们的团队​​ 

DHCS 正在招聘：​​ 

• Chief of Capitated Rates Development Division 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 MCPs. (Final filing date is January 30)​​ 

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

公开听证会：CalAIM 示范法案中关于儿童持续保障的修正案​​ 

1 月 29 日下午 1 时至 2 时，DHCS 将举行公开听证会（需提前登记），就加州推进和创新 Medi-Cal (CalAIM) 第 1115 节示范项目中有关儿童持续保险的拟议修正案征求利益相关者的意见。​​ 

DHCS is seeking approval from the Centers for Medicare & Medicaid Services (CMS) to include expenditure authority under Section 1115(a)(2) to receive federal matching funds to provide continuous coverage for children through the end of the month in which their 5th birthday falls, regardless of when they first enroll in Medi-Cal or the Children’s Health Insurance Program and any changes in circumstances that would otherwise cause a loss of eligibility. Implementation of this policy is contingent upon a state determination of available General Fund resources in 2024-2025 and subsequent fiscal years and CMS approval. Additional information is available on the DHCS CalAIM 1115 Demonstration and 1915(b) Waiver webpage.​​ 

导乐利益相关者实施工作组会议​​ 

1 月 31 日下午 2 点至 4 点，DHCS 将主办 Doula 利益相关者实施工作组会议，根据参议院第 65 号法案（2021 年法规第 449 章）和福利和机构法典第 14132.24 节，审查 Medi-Cal doula 福利的实施情况。​​ 

The meeting will be held via Zoom, with an in-person option at 1700 K Street, Room 1014, Sacramento, CA 95811. The meeting is open to the public. The link to attend the meeting virtually and the agenda are posted on the Doula Services as a Medi-Cal Benefit webpage. The workgroup will discuss how to ensure doula services are available to Medi-Cal members and make recommendations on outreach efforts. Please email DoulaBenefit@dhcs.ca.gov with any questions.​​ 

消费者中心利益相关方工作组 (CFSW) 虚拟会议​​ 

On February 2, beginning at 10 a.m., DHCS will hold the next CFSW meeting. The agenda, meeting materials, and instructions on how to join the meeting will be posted on the DHCS CFSW webpage by noon on January 31.​​ 

出生公平人口 ECM 网络研讨会​​ 

2 月 2 日下午 1:30 至 3:00，DHCS 将举办 "针对出生公平人群启动 ECM "网络研讨会（需提前注册），回顾针对出生公平重点人群 (POF) 的 ECM 愿景，以及实施的早期阶段。DHCS 与全州的 Medi-Cal MCP 和医疗服务提供者合作，于 1 月 1 日启动了针对出生公平 POF 的 ECM。本网络研讨会将概述出生公平 POF 的设计和操作指南；从医疗服务提供者的角度介绍他们是如何为启动出生公平 POF 的 ECM 做准备的，以及提供 ECM 的定制方法；并为 MCP、县和医疗服务提供者提供指导，帮助他们签订合同并准备提供 ECM 福利，以解决孕产妇发病率和死亡率较高的种族和民族群体在健康和分娩结果方面的已知差异。​​ 

该网络研讨会向所有人开放，但将特别引起 MCP 和与出生公平人群合作的服务提供商（包括县和社区组织）的兴趣。 有兴趣了解更多有关出生公平 POF 的 ECM 或推荐会员的提供商也可以参加。请参与者于 1 月 29 日前将问题提交至CalAIMECMILOS@dhcs.ca.gov 。 与会者将能够在网络研讨会期间提出问题。​​  

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​​ 

On February 13, from 12 to 1 p.m., DHCS will host a HACCP webinar (advance registration required) to share information with providers to help pediatric patients and their families maximize HACCP benefits. The training session will outline program requirements for families to apply for coverage. It will also outline 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​​ 

Medi-Cal 目标费率增长 (TRI)​​ 

Pursuant to Assembly Bill (AB) 118 (Chapter 42, Statutes of 2023), DHCS published, as part of the proposed 2024–25 Governor’s Budget, a plan for targeted increases to Medi-Cal payments or other investments, effective in 2025, across primary care, maternal care, behavioral health care, specialty care, women’s health services, public hospital services, community and hospital outpatient services, emergency services, and other domains. The proposed investments will be supported with funding from the Managed Care Organization (MCO) Tax, authorized by AB 119 (Chapter 13 , Statutes of 2023), and are designed to advance access, quality, and equity for Medi-Cal members and promote provider participation in the Medi-Cal program. These proposed investments are subject to obtaining all necessary legislative and federal approvals, as applicable. For more information, please visit the Medi-Cal Targeted Provider Rate Increases and Investments webpage and view the Medi-Cal TRI policy paper and MCO Tax-funded investments.​​ 

持续覆盖解除数据 90 天刷新​​ 

12 月 29 日，DHCS 向 CMS 提交了 2023 年 6 月至 8 月联邦解除合同数据的强制更新。 由于程序原因被停止享受 Medi-Cal 福利的个人有 90 天的时间向各县提交必要信息以完成续签。 由于提交解除数据的时间要求，之前的提交数据并不包括在 90 天的重新考虑期内恢复 Medi-Cal 的个人。 此次更新包括对之前提交的数据的刷新，其中包括个人在 90 天重新考虑期内的结果。​​ 

The updated data is accessible on the Medi-Cal Enrollment and Renewal Data webpage under the “Medi-Cal Continuous Coverage Unwinding Dashboards” section. Additionally, the California Health & Human Services Agency posted on its Medium page a piece by DHCS Director Michelle Baass about the 90-day data refresh.​​ 

2024 年 1 月 Medi-Cal MCP 过渡期​​ 

On January 1, DHCS achieved a significant milestone in its transformation of Medi-Cal with the launch of the new managed care contract and the MCP transition, under which approximately 1.2 million members gained new health plan options and/or transitioned to new MCPs (note: changing MCPs does not affect Medi-Cal member coverage or benefits). To facilitate a smooth transition between MCPs for members, DHCS created Continuity of Care protections to minimize disruptions to members’ care.​​ 

DHCS developed several resources to support members, providers, and other stakeholders with the transition, including the MCP Transition Member webpage with a county “lookup” tool, links to the member notices sent by Medi-Cal about MCP changes, member frequently asked questions in all threshold languages, and a Contact Us page for members to learn more about health plan changes. There are also transition resources for providers, MCPs, and stakeholders. More information about the transition is available in the 2024 MCP Transition Policy Guide and Medi-Cal Eligibility Division Information Letter Number I 23-54.​​ 

The MCP Transition Member webpage includes resources and information to support members’ transition. Members unable to resolve issues or questions after working with their MCP may contact DHCS’ Office of the Ombudsman at toll-free (888) 452-8609 or by emailing MMCDOmbudsmanOffice@dhcs.ca.gov.​​