DHCS Stakeholder News – April 14, 2023
專案更新
更新：長期護理福利標準化和會員轉換為受管理護理
DHCS published All Plan Letter (APL) 23-004 and updated the frequently asked questions (FAQ) for the skilled nursing facilities (SNF) long-term care carve-in based on stakeholder feedback. The APL includes updates on transportation to recurring appointments, provider communication on billing protocols, and exclusive services not subject to the directed payment policy. It also includes a new long-term services and supports liaison requirement. The FAQ and additional resources are available on the DHCS LTC Carve-In webpage.
SNFs experiencing challenges contacting their managed care plans (MCP) should email MCQMD@dhcs.ca.gov for assistance.
加利福尼亞州全州自動福利系統（CalSAWS）移民第三波
On April 24, Orange, Santa Barbara, and Ventura counties will join the CalSAWS consortium. This migration is part of the state’s plan to move all 58 counties, by December 31, 2023, to CalSAWS from the current split between two eligibility and enrollment systems: California Work Opportunity and Responsibility to Kids Information Network (CalWIN) and CalSAWS.
During the migration, the CalWIN system will be unavailable for the migrating counties from 5 p.m. on April 20 until they are active in CalSAWS on April 24 at 7:30 a.m. CalSAWS will be unavailable starting on April 21 at 3:30 p.m., and will be back online on April 24 at 7:30 a.m. The statewide application portal (BenefitsCal) will be available to applicants and members in these counties on April 24. There should be no disruption to the other ten CalWIN counties during this time.
Local county social services offices will be available on April 21 to address emergency services only. CalWIN counties will also have access to a CalWIN environment to allow county staff to see current case information and issue emergency benefits, as needed. Additionally, the CalWIN web portal will redirect applicants and members to county websites and Covered California to apply for benefits.
即將開幕：提供獲取和改變健康（PATH）與正義相關的第三輪資助申請
5 月 1 日，DHCS 將公開 PATH 正義介入計畫第 3 輪申請。第 3 輪資金將支援懲教機構、縣行為健康機構和其他涉及司法的利害關係人，因為他們需要實施人員、能力和/或 IT 系統，以協同規劃和實施釋前服務流程。如需詳細資訊，請造訪司法介入能力建構計畫網站。
加州醫療補助健康保健計劃 Rx
On April 21, Reinstatement Phase III, Lift 2 of the Medi-Cal Rx Reinstatement plan will be implemented, lifting the Transition Policy for 17 Standard Therapeutic Classes (STCs) for members age 22 and older. Additional information is available on the Medi-Cal Rx Reinstatement Spotlight. This is the second in a series of lifts to retire or phase out the grandfathering of historical prior authorizations (PAs) and claims. More information is available in the Medi-Cal Rx 30-Day Countdown – Phase III, Lift 2 communication.
加入我們的團隊
DHCS is hiring! DHCS has immediate openings for Information Officer I/II positions who will help DHCS keep the public informed about policy changes, program activities and departmental objectives.
DHCS 還招聘我們的財政、人力資源、法律、審計、健康政策和信息技術團隊。 有關更多信息，請訪問 CalCareers 網站。
DHCS is dedicated to preserving and improving the overall health and well-being of all Californians. DHCS’ mission is to provide the most vulnerable residents with equitable access to affordable, integrated, high-quality health care, and is currently transforming the Medi-Cal program to make sure it provides the care Californians need to live healthier, happier lives.
即將舉行的利害關係人會議和網絡
加利福尼亞推進和創新媒體技術（CalAIM）：管理長期服務和支持工作小組會議（MLTSS）
On April 19, from 10:30 a.m. to 12 p.m., DHCS will virtually host the CalAIM MLTSS and Duals Integration Workgroup meeting (advance registration required). Agenda topics will include updates on the continuous coverage requirement unwinding and the 2024 Medicare Medi-Cal Plan expansion counties, an overview of stakeholder and health plan feedback on the 2024 State Medicaid Agency Contract templates, and an overview of palliative care policy guidance for Dual Eligible Special Needs Plans.
前一個工作組會議的背景資料，成績單和視頻錄像，以及有關工作組的其他信息，都張貼在 CalAIM MLTSS 和 Duals 整合工作組網頁上。 如有任何疑問或意見，請致電 DHCS 電子郵件至 info@calduals.org。
人口健康管理諮詢小組會議
On April 26, from 12:30 to 2 p.m., DHCS will host the next PHM Advisory Group meeting (advance registration required). The meeting will provide feedback on DHCS’ proposed changes to the population needs assessment (PNA) that Medi-Cal MCPs are required to complete. DHCS envisions the modified PNA to promote greater alignment with local health departments and other community stakeholders, more robust community engagement, and a deeper understanding of member health, and social needs, and preferences from the communities in which they live. Stakeholders are encouraged to submit questions before the webinar to CalAIM@dhcs.ca.gov.
PATH 正義參與第三輪資訊會
On May 2, from 3 to 4 p.m., DHCS will hold an informational webinar (advance registration required) to provide application support for interested entities ahead of the July 30 application deadline for PATH Justice-Involved Initiative Round 3 funding. The meeting invite and additional details will be available on the Justice-Involved Capacity Building Program website. For questions, please contact justice-involved@ca-path.com.
如果你錯過了
California’s Reproductive Health Access Section 1115 Demonstration (CalRHAD)
On March 16, DHCS launched 30-day public and tribal public comment periods to solicit feedback on a proposed CalRHAD Medicaid Section 1115 demonstration; comments are due by April 17. DHCS is seeking approval from the Centers for Medicare & Medicaid Services to provide competitive grants to reproductive health providers to enhance capacity and access to sexual and reproductive health services, promote the sustainability of California’s reproductive health provider safety net, and benefit individuals enrolled in Medi-Cal and other individuals who currently face barriers to such access.
Additional information about the CalRHAD application and how to submit public comments are available on the CalRHAD webpage.