2023 年獲批准的國家計劃修訂
以下附件是加利福尼亞州計劃的修訂，最近被聯邦醫療保險和醫療補助服務中心（CMS）批准。 利害關係人可以按照文件附加的連結和說明來更新其副本。
- 23-0001 Updates the Current Dental Terminology (CDT) code set to CDT-23.
- 23-0003 Updates the reimbursement methodology for Durable Medical Equipment.
- 23-0005 Updates existing language to reflect the CDSS updated IHSS policy to allow telehealth reassessments and to update existing language to reflect CDSS IHSS QA updated practices.
- 23-0006 Renew and modify the existing facility-specific reimbursement methodology for Freestanding Skilled Nursing Facility Level-B (FS/NF-B) and Freestanding Subacute (FSSA) facilities.
- 23-0007 Provides supplemental payments for private hospital inpatient services for the service period of January 1, 2023 to December 31, 2024.
- 23-0008 為 1 月 1、2023 至 12 月 31, 2024 的服務期間提供私家醫院門診服務的補充金。
- 23-0009 Extends Medi-Cal eligibility to foster youth from any state who turned 18 years of age on or after January 1, 2023 so long as they otherwise meet the eligibility requirements of being under age 26, enrolled in Medicaid and exiting foster care at age 18 or older.
- 23-0010 Authorizes an Alternative Payment Methodology for Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) and a supplemental payment for Tribal health providers for the provision of eligible dyadic services.
- 23-0012 Disregards, under the authority of section 1902(r)(2) of the Social Security Act, all countable resources for all eligibility groups covered under the state plan to which a resource standard applies.
- 23-0013 Extends and modifies the Private Hospital Supplemental Fund program for the state fiscal year ending in 2024.
- 23-0014 Updates the Medi-Cal reimbursement methodology for State Fiscal Year 2023-24 Diagnosis Related Group Payments.
- 23-0015 Modifies the reimbursement methodology for Medi-Cal behavioral health services.
- 23-0016 Extends the Non-Designated Public Hospital Supplemental Fund program for the state fiscal year ending 2024.
- 23-0017 Reduces the payment cap for supplemental reimbursement to Martin Luther King Jr. – Los Angeles Healthcare Corporation (MLK-LA).
- 23-0019 更新臨床實驗室或實驗室服務的補償方法。
- 23-0020 Authorizes supplemental add-on payments to the fee schedule rates for eligible ground emergency medical transports provided July 1, 2023 through June 30, 2024.
- 23-0022 註冊牙科衛生師（RDHS）、註冊擴展職能牙科衛生師（RDHEF）和註冊替代診所牙科衛生師（RDHAPS）提供的服務與州的執業法律範圍相符。
- 23-0024 在 1915（i）州計劃中添加了協調家庭支持作為新服務。
- 23-0025 澄清在住院治療環境中提供護理協調、康復支援服務、同伴支援專家服務和藥物成癮治療的補償方法。
- 23-0026 更新康復精神健康服務、針對性病例管理、物質使用障礙治療服務、擴充物質使用障礙治療服務、藥物輔助治療以及社區型移動危機干預服務提供商類型和資格。
- 23-0027 在 Medi-Cal 計劃中採用學生人事服務認證的從業者作為獨特的提供者類型。
- 23-0028 更新獨立小兒半急性（FS/PSA）設施的比率設定方法，從 7 月 1，2023 生效，並將 FS/PSA 率年度更改為 1 月 1, 2024 生效的日曆年率。
- 23-0029 澄清和更新牙齒政策的分類信息，並澄清 Medi-Cal 的假牙（可移除）一般政策中的豁免。
- 23-0030 減少非 Magi 程序的資產驗證系統需求的範圍。
- 23-0032 指定長期護理設施的補償調整至一個日曆收費年度。
- 23-0033 允許加利福尼亞州工作機會和對兒童責任（CalWorks）受益人加入醫療補助計劃，而無需另行確定財務資格，生效於 2023 7 月 1。
- 23-0034 澄清現有預防服務政策，有關已批准成人疫苗的強制保障要求，以符合 CMS 指引。
- 23-0035 Authorizes reimbursement rate increases for primary care, obstetric, and non-specialty mental health services, which are effective for dates of service on or after January 1, 2024.
- 23-0036 Increases rates for independent living programs, adult residential homes and participant-directed day service and supported employment.
- 23-0037 Adds Licensed Professional Clinical Counselors (LPCCs) to the list of billable practitioners providing services at FQHCs, RHCs, and Tribal FQHCs. This SPA also makes a technical change to list “Clinical Psychologist” in place of “Licensed Clinical Psychologist” and “Licensed Psychologist.”
- 23-0043 Reimburse providers an ingredient cost, based on a submitted invoice price, for a covered outpatient drug when other pricing benchmarks are unavailable.
- 23-0044 Expands the prescribing authority for enteral formulae from physicians to include physicians, nurse practitioners, clinical nurse specialists, or physician assistants.
- 23-0045 Updates the methodology in which reimbursement for acute psychiatric inpatient hospital services for each Fee-For-Service and Short-Doyle Medi-Cal hospital is determined between the negotiating entity and the servicing hospital.
聯絡我們
You may email your questions and concerns regarding SPAs to Publicinput@dhcs.ca.gov. In your email, please include the SPA number in your question.