DHCS Stakeholder News – May 19, 2023
專案更新
加州醫療補助健康保健計劃 Rx
On May 19, Reinstatement Phase III, Lift 3 will be implemented, lifting the Transition Policy for 22 Standard Therapeutic Classes (STCs) for members age 22 and older. This is the third in a series of lifts to retire, or phase out, the grandfathering of historical prior authorizations (PA) and claims by reinstating NCPDP Reject Code 75 – Prior Authorization Required.
剩餘 46 個 STC 的 PA 規定將在第三階段第四階段重新實施，目前計劃於 2023 六月 23 實施。
加利福尼亞休息月報 2023 年四月
On May 22, DHCS will publish California’s submission of the federal “Unwinding Monthly Report” for the eligibility month of April 2023 to the Centers for Medicare & Medicaid Services (CMS) as part of the continuous coverage unwinding federal requirements. The report includes California’s updated estimate of total pending applications received between March 1, 2020, and March 31, 2023, that are still in a pending status as of April 30; total April 2023 annual renewals and renewal outcomes; and total Medi-Cal fair hearings pending more than 90 days as of April 30. The report also includes a description of California’s renewal timeline and policy during the unwinding period. This report will be posted to the DHCS Medi-Cal Enrollment webpage under “DHCS Continuous Coverage Unwinding Data.” Each monthly report will include the same measures, but specific for that month. DHCS will provide reports to CMS on or about the 20th of each month through at least June 2024.
加入我們的團隊
DHCS 現時有兩個新執行職位的職位：
- 人口健康管理部主任，該職位負責人口健康管理計劃的策略、政策、監督、監察和評估。
- 質量和健康平等部長，該職位負責臨床質量和健康平等倡議，計劃評估，質量和公平成果，以及跨 DHCS 計劃和交付系統的質量保證和績效改進活動。
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. For more information, please visit the CalCareers website.
即將舉行的利害關係人會議和網絡
認知障礙症護理-認知健康評估（CHA）虛擬培訓
從 5 月 19 日起，認知障礙症 Care Aware 每月在 CHA 上提供 Zoom 培訓（需要提前註冊），由加州大學歐文大學老人醫學專家領導。 CHA 是一種認知障礙症篩查方法，旨在在有需要認知篩查時對老年患者進行。 下一次培訓將於 6 月 2 日舉行。 基層醫療服務提供者和團隊可以在每月的第一個和第三個星期五加入我們，了解更多有關 CHA 如何賦予基層醫療服務提供者和他們的團隊能夠更好地檢測患者的認知障礙症。 提供免費的持續醫學教育和持續教育單位。
部落和印度健康計劃代表虛擬會議
On May 22, from 9:30 a.m. to 12 p.m., DHCS will host the quarterly Tribal and Indian Health Program representatives’ virtual meeting (advance registration required). This webinar will include a discussion of DHCS programs and initiatives of interest to tribal partners, and offer a forum to provide feedback on specific aspects of DHCS initiatives that directly affect tribes, Indian Health Programs, and American Indian Medi-Cal members. The next meeting will be held in August in Sacramento. The meeting agenda and other materials will be posted on the Indian Health Program webpage as they become available.
利害關係人諮詢委員會（SAC）和行為健康利害關係人諮詢委員會（BH-SAC）會議
5 月 24 日，上午 9 時 30 分至下午 3 時 30 分，DHCS 將主持 SAC 和 BH-SAC 混合會議（需提前註冊）。 它將以聯合會議開幕，主題由 SAC 和 BH-SAC 共享。 聯合會議後將舉行僅限 BH-SAC 的會議；沒有僅限 SAC 的會議。 與會者可以在位於薩克拉門托 1414 K 街的加州基金會虛擬或親身參加。 有關更多信息，請訪問 SAC 和 BH-SAC 網頁。
小組討論：建立合作夥伴關係，推出兒童及青少年加強護理管理（ECM）
6 月 23 日下午 1:00 至 2:30，DHCS 將舉辦一場虛擬活動（需提前註冊），介紹兒童和青少年加強護理管理 (ECM) 的願景，為 7 月 1 日推出的兒童和青少年重點人群 (POF) ECM 做準備。DHCS 的領導人將與醫療服務提供者、社區組織 (CBO) 和管理性照護計劃 (MCP) 的專案小組一起提供：
- 提醒兒童和青少年 POF 的設計和操作指引。
- 提供者如何準備為兒童和青少年 POF 推出 ECM 的例子。
- 向 MCP、縣和其他提供者有關 ECM 福利合約合約的指引。
本網絡研討會對公眾開放，與會者將有機會在會議期間提出問題。 這將對與 MCP 新手合約的兒童和青少年合作的 MCP 和提供者（包括縣和 CBO）特別有興趣。 請於六月十九日之前向 CalAIMECMILOS@dhcs.ca.gov 提交問題。
如果你錯過了
California Awards Millions to Strengthen State’s Opioid Response
On May 19, DHCS awarded more than $12 million in grants to strengthen the state’s opioid response as part of the California’s $1 billion plan to tackle the opioid epidemic. The awards include $7.9 million to 20 DHCS-licensed, residential substance use disorder (SUD) treatment facilities throughout the state as part of the Medication Assisted Treatment (MAT) Expansion Project, $3.5 million to 23 organizations through the Tribal Urban Indian Defined Best Practice program, and $1.05 million to seven organizations through the California Native MAT Network for Healing and Recovery.