利益相关者听证会常见问题​​ 

九月30 ， 2025​​ 

以下是卫生保健服务部（DHCS）在 9 月30 日利益相关者听证会上收到的大多数问题的答复，2025 。如果您的问题没有得到答复，请向下面列出的相应电子邮件地址发送电子邮件：​​ 

• For questions related to provider enrollment, please contact dhcspedstakeholder@dhcs.ca.gov​​ 

• 有关 Medi-Cal 一般福利的问题，请联系​​  Medi-Cal.Benefits@dhcs.ca.gov 。​​ 

• For questions specific to Managed Care, please contact MCQMD@dhcs.ca.gov.​​ 

提供商注册​​ 

1. Is there any change for Qualified Autism Service (QAS) provider organizations who only have an administrative location and do not see patients in a center/clinic, and only in the community?​​ 

对于由一个以上的合格医疗服务提供者组成并打算代表合格医疗服务专业人员和辅助专业人员收费的合格医疗服务提供者组织，其要求没有变化。自17 年 11 月起，2025 ，健康与社会服务部仅更新加州医 疗保险医疗服务提供者注册要求和程序，特别针对由委员会认证的行为分析师（BCBA）组成的 QAS 申请者，这些行为分析师仅为自己向加州医疗保险计划收费。​​ 

2. If I am a new QAS sole BCBA provider, do I need to wait until November 17, 2025 to register myself or can I get credentialed prior to November 17, 2025?​​ 

目前尚未注册且没有注册途径的提供者，如不在其服务地址提供面对面服务的 BCBA 个人，将有资格在公告于 11 月生效后注册17,2025 。如果 BCBA 个人在符合所有既定营业地要求的诊所或其他地点提供服务，他们将有资格在 11 月之前注册17 ，2025 。​​ 

3. Should we remove all QAS professionals that we already submitted in PAVE?​​ 

不，DHCS 不建议您从先前提交的注册申请中删除所有先前报告的合格会计标准专业人员和辅助专业人员。另请注意，自17 年 11 月起，2025 ，您将不再需要根据《加州法规汇编》（CCR）第 22 篇第 51000.40 节的规定每 35 天报告或更新一次此信息。​​ 

4. Are Medi-Cal Health Plans expected to validate Medi-Cal enrollment for QAS providers providing behavioral health treatment services? If yes, how will DHCS expect plans to validate if QAS providers are no longer added to the E-form application?​​ 

Providers will receive an approval letter within PAVE when their application is approved. Enrolled fee-for-service (FFS) providers will also be included on the Medi-Cal Open Data Portal. When a QAS provider organization enrolls to bill on behalf of QAS providers, QAS professionals, and QAS paraprofessionals, these individuals themselves are not enrolled in Medi-Cal to bill directly and would thus not be validated as an enrolled Medi-Cal provider. Only the enrolling QAS provider organization would be enrolled. Prior to this bulletin, managed care plans were only able to validate that the QAS organization was successfully enrolled in Medi-Cal – that is unchanged.​​ 

5. Effective November 17, 2025, for organizational QAS enrollments, we will no longer be required to roster any of our QAS providers, professionals, or paraprofessionals?​​ 

自 11 月 17、2025 日起，QAS 提供者申请人将不再需要在 Medi-Cal 注册申请中报告他们打算为其收费的每个 QAS 提供者、专业人员或辅助专业人员。相反，质量保证服务提供机构将被允许对这些个人的资格进行证明。他们必须维护一份最新的内部名册，其中应包括：​​ 

• 国家提供商标识符 (NPI)​​ 
• 全名​​ 
• 任何适用的许可证、认证或注册编号​​ 

该名册必须在DHCS要求时或在审计期间提供，并且不需要作为注册过程的一部分通过PAVE系统提交。​​ 

6. Do QAS professionals & paraprofessionals providing services need anything submitted when they join a group that is already enrolled?​​ 

但是，QAS 医疗服务提供者组织必须为其打算向 Medi-Cal 计划付费的每个医疗服务提供者保存某些信息。更多信息请参见问题 5 的答复。​​ 

7. The presentation slide stated that you need to provide BCBA information upon request. When are those requests made? Does something specific trigger that?​​ 

QAS 提供机构至少应保存以下信息，并应 DHCS 的要求提供给 DHCS 审查，信息包括每位 QAS 提供者、QAS 专业人员和 QAS 辅助专业人员：NPI、姓名（包括姓和名）以及提供行为健康治疗服务的 QAS 提供者的任何适用的专业执照号码、认证号码或注册号码。根据州和联邦法律以及供应商协议，DHCS 保留对供应商进行审计或索取记录的权利。​​ 

8. Can you confirm that Medi-Cal MCPs are not required to verify Medi-Cal enrollment for BCBAs?​​ 

Medi-Cal 管理性護理計劃 (MCP) 必須為有資格加入 Medi-Cal 付費服務的醫療服務提供者確認註冊。自17 年 11 月起，2025 ，DHCS 将开始接受 BCBA 个人的注册申请，这些 BCBA 在其住所或其他行政地点工作，但不在此地址提供实际服务。​​ 

9. Is there a new deadline for Medi-Cal enrollment or will each organization be required to be enrolled by November 1, 2025?​​ 

No, there is no deadline to enroll in fee-for-service Medi-Cal. If you are contracted with or intend to contract with a Medi-Cal managed care plan (MCP), please direct questions regarding credentialing requirements from the plans directly to the plan(s) for which you are contracted or intend to contract. The Medi-Cal Managed Care Plan directory contains contact information for each plan.​​ 

10. Is the intent to support solo practitioners starting out, while holding groups to a higher standard of infrastructure? Will the policy eventually expand to groups, or is this distinction meant to remain permanent?​​ 

该豁免仅适用于仅为其个人提供的服务收费而注册的 BCBA 个人，他们没有固定的营业场所 (EPOB)。DHCS 致力于继续与利益相关者进行接触和讨论，但必须坚持联邦和州的计划完整性标准，包括与组织注册相关的预防欺诈协议。​​ 

11. Can non-profit organizations apply for an exemption?​​ 

QAS 医疗服务提供者可以非营利组织的身份注册，因为对注册为此类医疗保健企业的实体类型没有限制。但是，如果您打算以社区组织 (CBO) 的身份注册并收取行为健康治疗服务费，您就必须以 501(c)(3) 非营利组织的身份注册，而且这种注册途径没有豁免。如需了解更多信息，请查阅这些公告：​​ 

更新的 Medi-Cal 注册要求和社区组织、地方卫生辖区和县儿童与家庭事务委员会的程序​​ 

针对社区组织、地方卫生管辖区和县儿童和家庭委员会的最新 Medi-Cal 注册要求和程序（针对提供行为健康治疗服务的 CBO 提供商，于5年 5 月2025修订）​​ 

此外，如果您打算以专业医疗服务提供者类型（如执业婚姻和家庭治疗师或医生）的途径注册，那么您将没有资格以非营利实体的身份注册，而需要以专业公司的身份注册，以便为他们的服务向 Medi-Cal 帐单。​​ 

12. Under this policy, when an individual BCBA enrolls without a business address, are they expected to personally deliver all services (one-to-one, family training, supervision), or do they also bill for technician delivered services under their supervision? We’d like to better understand the reasoning to why the new policy allows individual BCBAs to enroll without a business address, but small group practices with only two or three BCBAs are still required to maintain one?​​ 

对于由多个独立的 QAS 提供者组成的 QAS 提供者组织，其打算代表 QAS 专业人员和辅助专业人员进行收费，现有要求没有任何变化。这些组织必须继续满足所有适用的Program要求。​​ 

健康与社会服务部将继续致力于与利益相关者的合作，以更好地支持合格医疗服务提供者群体的需求的方式完善政策。收到的反馈意见将继续为今后的政策制定提供参考。​​ 

13. For a QAS organization that has QAS professionals or paraprofessionals that they are billing for, do they count as an individual and are exempt from this requirement?​​ 

不，对 QAS 提供商公告的更新仅适用于打算注册仅为自己的服务付费，并将其住所或其他非临床地点列为其行政地址的 BCBA 个人。这些个人不受 EPOB 要求的限制，因为他们不在该地点提供上门服务。​​ 

但是，如果 QAS 机构打算为辅助专业人员提供的服务收费，则不适用此注册途径。这些组织必须遵循标准注册流程，并满足所有计划要求。​​ 

14. What is the difference in enrolling as a QAS organization or a Community-Based Organization (CBO)?​​ 

QAS 提供机构和个人加入 Medi-Cal 计划，仅为行为健康治疗服务付费。​​ 

社区组织 (CBO) 参加Medi-Cal Program ，可以就社区卫生工作者 (CHW)、哮喘预防 (AP)、司法相关 (JI) 和/或行为健康治疗服务进行收费。​​ 

计费​​ 

1. Can we get more clarification on the BCBAs billing on their own or can we bill under our organization as we already do?​​ 

BCBA 可以个人或组织的名义注册和收费。​​ 

2. We are a QAS organization, and as of November 17, 2025, we will no longer be required to add any additional providers. Will we still bill under individual providers, or would we bill under one designated provider for all services?​​ 

拥有第二类 NPI 的 QAS 机构将以该第二类 NPI 为所有服务计费。​​ 

其他资源​​ 

1. Why does an individual QAS provider have to only provide benefits to individuals with autism when the benefit is not limited to individuals with autism?​​ 

行为健康治疗不仅限于自闭症儿童，所有 21 岁以下的 Medi-Cal 儿童，只要医生或心理学家认定有医疗必要，都可以获得治疗。如果您想进一步了解此福利涵盖哪些服务，请发送电子邮件至福利部门： MediCal.Benefits@dhcs.ca.gov 。​​ 

2. Will you send this PowerPoint? Or will this recording be on the website?​​ 

公听会的录音将发布在公告网页上：https://www.dhcs.ca.gov/Pages/stakeholder-hearing-qas-providers-bhts.aspx​​ 

3. Our MCO, CalOptima, states that we need to have our newly added BCBAs added to Medi-Cal PAVE. However, we can’t currently add to the application. How do we add new providers as BCBAs to the PAVE portal, as currently the account states no changes can be made?​​ 

在 11 月之前，17 ，2025 ，您可以在申请表中更新您的名册；但这并不是必须的。17,2025 年 11 月以后，申请表中将不再要求提供这些信息。​​ 

If you’re having difficulty with your PAVE account, please email DHCSPEDstakeholder@dhcs.ca.gov and we can assist you.
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4. How do we get notified if a QAS provider is not validated with Medi-Cal?​​ 

DHCS 提供商注册不发送 QAS 提供商 Medi-Cal 验证通知。​​ 

You can check the status for providers for fee for service Medi-Cal by going to the Medi-Cal Open Data Portal.​​