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DHCS 覆盖大使
DHCS 已发起全州范围的活动，帮助 Medi-Cal 受益人保留他们的 Medi-Cal 保险或加入其他保险。
In the largest effort of its kind, across the country, Medicaid (e.g., Medi-Cal) and the Children’s Health Insurance Program will soon begin the process of redetermining eligibility for about 85 million people who use these programs to access the health care they need. This large, complex effort will be triggered by the official end of the COVID-19 public health emergency (PHE) and the end of the federal Medicaid continuous coverage requirement that was implemented as part of the Families First Coronavirus Response Act.
由于加州计划恢复正常的 Medi-Cal 资格审核工作，大约 1450 万受益人将需要重新确定其承保资格。 在 PHE 结束时，各县将根据下一个年度续订日期（滚动进行而不是一次性进行）重新确定所有受益人的 Medi-Cal 资格。 该程序的结果是，两百万至三百万受益人不再有资格享受 Medi-Cal。
DHCS has been actively preparing for this unprecedented event for many months, and has implemented a two-phased communication campaign to reach beneficiaries with messages across multiple channels using trusted partners called DHCS Coverage Ambassadors. DHCS encourages its partners, including local county social services agencies, managed care plans (MCPs), health enrollment navigators, clinics, providers, and community stakeholders, to sign up to serve as DHCS Coverage Ambassadors.
For Phase 1 of the campaign, DHCS recently launched a customizable Medi-Cal Continuous Coverage toolkit and webpage to help trusted entities and individuals act as DHCS Coverage Ambassadors to provide critical information to beneficiaries and to help preserve health coverage for millions. The toolkit includes social media, call scripts, noticing, and website banners. During Phase 1, trusted entities and individuals encourage beneficiaries to update their contact information with their local county offices, if they have not done so already. Beneficiaries need to know what to expect and what they can do to keep their Medi-Cal health coverage. Those no longer eligible for Medi-Cal may qualify for tax subsidies that allow them to buy affordable Covered California coverage.
第 2 阶段计划在 COVID-19 PHE 结束前约 60 天启动，旨在鼓励受益人更新联系信息并向当地县办公室报告任何情况变化，以及查看邮件中是否有即将到来的续订包。 随着有更多工具包或资源可用，DHCS 将通过电子邮件发送重要更新，让 DHCS 覆盖大使随时了解情况，以便他们能够传播信息。
DHCS 知道，在我们共同采取措施摆脱 COVID-19 PHE 之际，分享信息和听取您的反馈非常重要。 我们需要所有人通力合作，帮助我们的受益人了解他们必须做什么以及何时做才能维持或转变他们的医疗保险。 感谢您一直以来的合作。
Medi-Cal COVID-19 疫苗接种激励计划
DHCS allocated up to $350 million to incentivize COVID-19 vaccination efforts in the Medi-Cal managed care delivery system from September 1, 2021, through February 28, 2022. Medi-Cal MCPs are eligible to earn incentive payments for activities designed to close vaccination gaps with their enrolled members, and to address vaccine uptake disparities for specific age and race/ethnicity groups. The second outcome ascertainment period for the program ended on January 2. Between November 1 and January 2, the total vaccination rates showed improvement in all reported measures. Statewide, the target (59.2 percent) was exceeded (61.4 percent) for improving the percentage of primary care providers in MCP networks giving the COVID-19 vaccine in their office. On January 2, target goals for all vaccine outcome measures increased to closing two-thirds of the gap between Medi-Cal and county rates, which was a challenge for plans to meet. Three beneficiary sub-groups (ages 12-25 years, African-Americans, and American Indians/Alaska Natives) were successful in closing more than one-third of the gap at this time point, while an additional three groups (overall age 12+ years, 50-64 years, and 65+ years) were within 2 percent of closing one-third of the gap. Specifications for the High Performance Pool program were released to MCPs. For more information, please refer to All Plan Letter (APL) 21-010, Attachment A.
老年人拓展
On May 1, California will expand state-funded full-scope Medi-Cal benefits to individuals who are 50 years of age or older, regardless of citizenship or immigration status. This coverage expansion includes approximately 185,000 individuals 50 years of age or older who are currently enrolled in restricted scope Medi-Cal. Under this coverage expansion, eligible individuals will be able to access the full range of benefits available to Medi-Cal beneficiaries who have full-scope coverage, including no-cost/low-cost quality health, behavioral health, substance use disorder services, and dental services through organized delivery systems under the Medi-Cal program. Enrolled individuals in restricted-scope Medi-Cal who are eligible under this expansion will receive a My Medi-Cal Choice packet in the mail so they can enroll in a Medi-Cal managed care plan for coordinated, integrated medically necessary services. Once enrolled in a plan, they can select a primary care doctor in their plan network. For more information, please visit the DHCS website.
加州 55 岁及以上居民的医疗保健调查
In April, DHCS will release the results from a survey of California adults ages 55 and older on health care needs, services, and coverage, including Medicare, Medi-Cal, and other health coverage. The survey included questions about respondents’ medical needs, coordination of and access to health care services, caregiver experiences, and the need for and access to in-home care and services. Interviews for this survey were conducted between January 25 and February 10, 2022. A total of 1,540 individuals completed the survey. It was administered by NORC at the University of Chicago, with funding from The SCAN Foundation and oversight from DHCS’ Office of Medicare Innovation and Integration. The survey results will be posted on the DHCS website.