热门新闻 

加州提交扩大镰状细胞病治疗的申请 

3月11日，DHCS向CMS申请参与开创性的细胞和基因治疗（CGT）准入模式。如果获得批准，DHCS 将实施这项多年计划，以扩大 Medi-Cal 会员获得创新且可能改变人生的镰状细胞病 (SCD) 疗法的机会。镰状细胞病是一种严重的遗传性血液疾病，对非洲裔人群的影响尤为严重。基因疗法是治疗镰状细胞贫血症的一种突破性方法。然而，这些疗法的费用非常高昂，使得患者和医疗补助计划（包括 Medi-Cal）难以获得这些疗法。CGT 准入模式通过协商回扣制度来应对这一挑战，该制度将这些治疗费用与患者的治疗结果挂钩。如果治疗效果未达到预期的健康改善效果，药品生产商将向医疗补助计划提供回扣，以帮助确保财务可持续性，同时扩大医疗服务的覆盖范围。如果加州获得批准，符合条件的 Medi-Cal 会员将获得基因治疗、生育力保存服务、病例管理、旅行援助和行为健康支持。CMS预计将在11年的运行期内测试该模型。如果获得批准，加利福尼亚州将于7月1 、 2025开始参与该模式。

传统医疗保健实践有利于实施 

On March 21, DHCS published Behavioral Health Information Notice (BHIN) 25-007 – Traditional Health Care Practices Benefit Implementation. This policy, the result of years of dedicated effort and advocacy from California Tribal leaders and partners, provides guidance on the implementation of the traditional health care practices benefit in the Drug Med-Cal Organized Delivery System (DMC-ODS). The federal Centers for Medicare & Medicaid Services (CMS) approved DHCS to cover traditional health care practices provided by Indian Health Care Providers (IHCP) for Medi-Cal members in DMC-ODS counties through December 31, 2026, unless extended or amended. Traditional health care practices encompass two new service types: Traditional Healer and Natural Helper services. DMC-ODS counties will cover Traditional Healer and Natural Helper services provided by IHCPs to Medi-Cal members who meet DMC-ODS access criteria. For questions about traditional health care practices or this BHIN, please email traditionalhealing@dhcs.ca.gov. 

Additionally, on April 22, DHCS will present an overview of BHIN 25-007 at the Tribes and Indian Health Program Representatives meeting (advance registration required). The presentation is open to the public and will review policy guidance to support IHCPs and DMC-ODS counties in implementing this new benefit. Attendees are encouraged to submit questions in advance to traditionalhealing@dhcs.ca.gov with the subject line “Traditional Health Care Practices Implementation.” 

项目更新

现已推出：闭环转诊实施指南网络研讨会资料 

Effective July 1, 2025, Medi-Cal managed care plans will be required to implement Closed-Loop Referral (CLR) requirements for Enhanced Care Management (ECM) and Community Supports. CLR requirements aim to increase the number of Medi-Cal members successfully connected to these benefits and services. By improving information collection processes, managed care plans will be able to better support individual referrals and address system-level gaps in referral practices and service availability that impact members. DHCS released materials from the February 13 webinar (posted under Informational Webinars) to share more details about these requirements. In the webinar, DHCS provided: 

• The Department’s goal and motivation for releasing new CLR requirements.
• CLR 要求如何通过简化推荐跟踪、支持和监控工作来改善会员推荐流程。 
• 一个示例用例场景，说明 CLR 要求如何帮助成员获得医疗定制膳食社区支持。 

如对加州推进和创新 Medi-Cal (CalAIM) 人口健康管理计划有任何疑问或意见，请通过PHMSection@dhcs.ca.gov联系 DHCS。

加入我们的团队

DHCS 正在为其财务、人力资源、药房、行为健康和其他团队招聘人员。如需了解更多信息，请访问 CalCareers 网站。 

即将举行的利益相关方会议和网络研讨会

DHCS 在活动日历上发布即将召开的公开会议。

覆盖大使网络研讨会 

太平洋时间 3 月 25 日上午 11:00 至中午 12:00，DHCS 将举办 "承保大使 "网络研讨会（需提前注册），提供有关医疗保健选择和 Medi-Cal 更新的信息。承保大使帮助宣传加州医疗保险福利、注册信息以及旨在为所有人创建健康加州的新项目。请访问 "报道大使"网站了解更多信息，或订阅成为 "报道大使"，定期接收最新信息。

管理长期服务和支持 (MLTSS) 和双重集成工作组会议 

On March 27, from 10 a.m. to 12 p.m. PDT, DHCS will host the CalAIM MLTSS and Duals Integration Workgroup meeting (advance registration required). The workgroup is a stakeholder collaboration hub for CalAIM MLTSS and integrated care for dual eligible members. It allows stakeholders to provide feedback and share information about policy, operations, and strategy for upcoming changes to Medi-Cal and Medicare. The meeting agenda includes updates on Medicare enrollment data for dual eligible members, the Dual Eligible Special Needs Plan (D-SNP) Dashboard, D-SNP initiatives, and the D-SNP State Medicaid Agency Contract and Policy Guide. It also includes data updates on Enhanced Care Management and Community Supports for dual eligibles and a Community Supports service spotlight presentation on select service definition updates. 

More information, background materials, transcripts, and video recordings of previous workgroup meetings are posted on the CalAIM MLTSS and Duals Integration Workgroup webpage. For questions or comments, please email DHCS at info@calduals.org.  

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 March 27, from 12 to 1 p.m. PDT, DHCS will host the quarterly HACCP webinar for medical providers and hearing professionals. For more information and to register, please visit DHCS’ HACCP webpage. Registration information will be posted as the webinar date approaches. 

如果你错过了

现已开放：提供访问和转变健康 (PATH) 能力以及基础设施转型、扩展和发展 (CITED) 第 4 轮申请 

On January 6, DHCS opened the PATH CITED Round 4 application window, which includes funding opportunities to support the implementation of the new transitional rent Community Support. The PATH CITED initiative provides funding to build the capacity and infrastructure of on-the-ground partners, including community-based organizations, hospitals, county agencies, Tribes, and others, to successfully participate in Medi-Cal. All organizations providing the transitional rent Community Support must do so in partnership with their county behavioral health department. To demonstrate this partnership, all CITED applicants planning to request funding to support the transitional rent Community Support must also submit a Letter of Support in collaboration with the county behavioral health department.  

申请 PATH CITED 第 4 轮资助的截止日期为 5 月2 2025太平洋夏令时间晚上 11:59。指导文件和申请可在 PATH CITED 网页上找到。如有任何问题，请发送至cite@ca-path.com 。