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DHCS 獲批准參與 Medi-Cal 細胞和基因治療訪問模型

美國醫療保險和醫療補助服務中心 (CMS) 的醫療保險和醫療補助創新中心批准了 DHCS 參與開創性的細胞和基因治療 (CGT) 准入模式，該模式於 7 月1 、 2025日開始實施。這項為期多年的計畫將擴大 Medi-Cal 會員獲得拯救生命的鐮狀細胞疾病 (SCD) 基因療法的機會。鐮狀細胞疾病是一種嚴重的遺傳性血液疾病，對非裔族群的影響尤其嚴重。這些療法有可能改變人們的生活，而這項措施有助於確保費用不會成為最需要這些療法的加州人的障礙。

Initially, the CGT Access Model will focus on access to gene therapy treatments for people living with SCD, specifically targeting therapies like Vertex’s Casgevy and Bluebird’s Lyfgenia. It aims to improve health care outcomes for Medi-Cal members by facilitating access to transformative therapies, while managing costs through outcomes-based agreements between CMS, manufacturers, and state Medicaid agencies. DHCS will work with CMS on onboarding activities in the coming weeks and will share more detailed information as it becomes available.

專案更新

加州1115豁免批准不受影響

DHCS partners may be aware that on April 10, CMS announced it will not approve new requests from states for federal matching funds for state expenditures on Designated State Health Programs (DSHP) and Designated State Investment Programs (DSIP). These funds, approved by CMS, allow states to support health care delivery system transformations not typically covered by Medicaid.

This announcement does not affect California’s previously approved DSHP funding, including initiatives under the California Advancing and Innovating Medi-Cal (CalAIM) and Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) 1115 waivers, which remain federally approved and operational. Specifically, the Providing Access and Transforming Health (PATH) initiative under CalAIM will continue. In BH-CONNECT, DSHP funds support the implementation of the Behavioral Health Workforce Initiative program, which is expanding the supply and competencies of behavioral health providers who commit to serving Medi-Cal members. This initiative is designed specifically to support the Medi-Cal behavioral health workforce with strong requirements for participating in high-volume Medi-Cal provider settings and is not a general student loan repayment program.

DHCS 始終致力於為加州人民提供公平的優質醫療保健服務，從而為所有加州人創造一個健康的加州。我們感謝 Medi-Cal 的醫療服務提供者和社區合作夥伴，我們將齊心協力，全力推動醫療體系改革，以改善醫療效果。

加入我們的團隊

DHCS 正在尋找有才華和有動力的人，以作為：

• Chief of the Benefits Division (BD). The Chief of BD leads the development, implementation, and administration of medical coverage policies for health care services provided by the state’s Medi-Cal program. The Chief also oversees several specialty programs within Health Care Benefits and Eligibility, including Every Woman Counts, Prostate Cancer Treatment, and Hearing Aid Coverage for Children. Applications must be submitted by April 18.

• Chief of the Investigations Division (ID). The Chief of ID leads all investigation activities for DHCS programs, including Medi-Cal. These activities include fraud data analytics, the Medi-Cal Fraud Hotline, complaint intake, investigative audits, and provider and member fraud investigations. Additionally, the Chief of ID is responsible for developing and implementing policies and processes related to fraud, waste, and abuse investigations under the division’s purview and ensuring compliance with all applicable federal and state laws, rules, and regulations. Applications must be submitted by April 25.

DHCS 還正在招聘其會計、行為健康和其他團隊。有關更多信息，請訪問 CalCareers 網站。

即將舉行的利害關係人會議和網絡

DHCS 在活動日曆上發布即將到來的公開會議。

傳統醫療保健實踐福利實施

On April 22, DHCS will present an overview of Behavioral Health Information Notice (BHIN) 25-007 – Traditional Health Care Practices Benefit Implementation at the Tribal and Indian Health Program Representatives meeting (1 to 4 p.m. PDT, advance registration required). The presentation is open to the public and will review policy guidance to support Indian Health Care Providers and Drug Medi-Cal Organized Delivery System counties in implementing this new benefit. Attendees are encouraged to submit questions in advance to traditionalhealing@dhcs.ca.gov with the subject line “Traditional Health Care Practices Implementation.” For questions about traditional health care practices or this BHIN, please email traditionalhealing@dhcs.ca.gov.

DHCS 每季度舉辦部落和印第安人健康計劃代表會議，以促進與部落合作夥伴就 DHCS 各項舉措的早期參與和討論，這些舉措會對部落、印第安人健康計劃和美國印第安人 Medi-Cal 成員產生具體影響。更多信息，請訪問印第安人健康計劃網頁。

選擇家庭，第二部分：跨性別和性別多元人的避孕和生育能力 

五月五日，上午十時至十一時三十分PDT，DHCS 將舉辦「選擇家庭」，第 2 部分：跨性別和性別多元人的避孕和生育網絡研討會（需要進階註冊）。跨性別和性別多樣性（TGD）人代表患者人群日益增長的子組，但許多人繼續報告提供者對 TGD 健康方面缺乏知識。本會議將基於本網絡研討會系列第 1 部分中所介紹的 TGD 健康術語和能力基本要素，通過審閱有關避孕、生育和家庭建設諮詢的基於實證的建議。如果您無法參加實時網絡研討會，稍後將在 Family PACT 網站上提供網絡研討會的成績單和記錄以及其他資源。

利害關係人諮詢委員會（SAC）/行為健康（BH）-SAC 會議

5 月 21 日，太平洋標準時間上午 9 時 30 分至下午 3 時，DHCS 將在薩克拉門托 1700 K 街（一樓會議室 17.1014）舉辦混合 SAC/BH-SAC 會議（需提前註冊才能在線和親身參加）。SAC 為 DHCS 提供有價值的意見和反饋，以提供公平獲取優質醫療保健的努力。BH-SAC 為 DHCS 提供有關行為健康計劃的意見，這是作為將行為健康與更大的醫療保健系統整合在一起努力的一部分創建的一部分。會議議程和其他會議材料將隨著會議日期臨近發布。有關更多信息，請發送電子郵件 SACinquiries@dhcs.ca.gov 或 BehavioralHealthSAC@dhcs.ca.gov。

如果你錯過了

提案 35：保護獲得醫療保健法例-SAC 

今天，DHCS 召開了第一次《保護醫療保健法案》特別諮詢委員會會議。該委員會負責就 2024 年《保護醫療保健法案》（第 35 號提案）的各項組成部分的製定和實施向 DHCS 提供建議。本次會議標誌著根據第 35 號提案要求進行的正式利害關係人諮詢程序的開始。有關會議的更多信息，請訪問“保護醫療保健服務法案-SAC”網頁。此外，為了協助澄清加州醫療管理機構稅的事實，並概述第 35 號提案的實施進度，DHCS 發布了常見問題。如有任何疑問，請發送電子郵件至 DHCSPAHCA@dhcs.ca.gov。 {cph0

現正開放：提供存取和轉型健康（PATH）容量和基礎設施轉型、擴展和開發（CITED）第四輪申請

On January 6, DHCS opened the PATH CITED Round 4 application window, which includes funding opportunities to support the implementation of the new transitional rent Community Support. The PATH CITED initiative provides funding to build the capacity and infrastructure of on-the-ground partners, including community-based organizations, hospitals, county agencies, Tribes, and others, to successfully participate in Medi-Cal. All organizations providing the transitional rent Community Support must do so in partnership with their county behavioral health department. To demonstrate this partnership, all CITED applicants planning to request funding to support the transitional rent Community Support must also submit a Letter of Support in collaboration with the county behavioral health department.

申請 PATH CITED 第四輪資助的截止日期為台灣時間 2 月 2025 (台灣時間) 晚上 11 時 59 分。指引文件和應用程序可在 PATH CITED 網頁上找到。如有任何疑問，請發送至 cited@ca-path.com。