April 29. 2024 – Stakeholder Update
熱門新聞
DHCS 慶祝行為健康治療中心的絲帶切割
On April 25 and 26, DHCS celebrated the addition of two new facilities that will provide lifesaving treatment for Californians with mental health and substance use disorders (SUD). Paving the Way Foundation in Los Angeles County and Center Point Drug Abuse Alternatives Center in Sonoma County are expanding behavioral health treatment and recovery options in their local communities. These are among the first of many community treatment sites supported by the Behavioral Health Continuum Infrastructure Program and are under construction now in 49 counties. Even more sites will be funded and built, thanks to recently approved Proposition 1 bonds.
專案更新
Medi-Cal Rx 索償的新代碼 1 診斷要求
Effective April 30, Code 1 Diagnosis Requirement – Reject Code 80 claim utilization management (UM) edits will be implemented for members 22 years of age and older. Medi-Cal Rx will use diagnosis code(s) from the member’s Medi-Cal medical record to meet the Code 1 diagnosis restriction. Code 1 drugs are subject to prescription documentation requirements, and prescribers and pharmacy providers must document the treatment diagnosis and keep that information readily available for auditing purposes. Code 1 diagnosis requirements can be met in one of four ways: provide a diagnosis with the prescription, communicate the diagnosis verbally to the pharmacy provider, submit a prior authorization request with the diagnosis, or use an acceptable diagnosis code that is on file in the Medi-Cal data system. Members 21 years of age and younger are not impacted.
Smile，加利福尼亞移動牙科車之旅繼續進行
On May 4, the Smile, California mobile dental van tour will stop in Huntington Park. During the event, individuals will have access to various dental services, such as exams, X-rays, cleaning, and fluoride applications. More information about Medi-Cal-covered dental services is available on the Smile, California website.
加入我們的團隊
DHCS 正在招聘通信，人力資源，審計，健康政策，信息技術和其他團隊。 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
Medi-Cal Children’s Health Advisory Panel (MCHAP)
On May 1, from 10 a.m. to 2 p.m., DHCS will hold the MCHAP hybrid meeting (advance registration required). MCHAP advises DHCS on policy and operational issues that affect children in Medi-Cal. The panel consists of a 15-member advisory body whose members include recognized stakeholders and experts in their fields, medical professionals, advocates, and parent members. If you are interested in receiving information about MCHAP meetings or have general inquiries, please email MCHAP@dhcs.ca.gov.
以消費者為中心的利益相關者工作小組（CFSW）
On May 3, from 10 to 11:30 a.m., DHCS will convene the CFSW, which provides stakeholders an opportunity to review and provide feedback on a variety of consumer messaging materials. The forum focuses on eligibility- and enrollment-related activities and strives to offer an open discussion on Medi-Cal policies and functionality. Meeting materials, including the meeting agenda, will be posted to the CFSW webpage no later than May 1. Please email your questions to DHCSCFSW@dhcs.ca.gov.
美迪卡牙科洛杉磯利益相關者會議
5 月 14 日，下午 1 時至 3 點，DHCS 將主持洛杉磯 Medi-Cal Dental 會議。 DHCS 將分享有關新和即將舉行的活動的更新和信息。 會議還為牙科利益相關者提供了一個論壇，以與 Medi-Cal Dental 團隊分享意見，以幫助改善口腔保健服務的提供。 會議信息將發布在 D HCS Medi-Cal 牙科洛杉磯利益相關者會議網頁上。 其他材料將在會議開始前或在可用後發布在網頁上發布。 請將您的問題發送至 dental@dhcs.ca.gov。
利害關係人諮詢委員會（SAC）/行為健康（BH）-SAC 會議
On May 29, from 9:30 a.m. to 3 p.m., DHCS will convene the SAC/BH-SAC hybrid meeting (advance registration required). The meeting will include an update on Proposition 1 implementation. SAC provides DHCS with valuable input on ongoing California Advancing and Innovating Medi-Cal (CalAIM) implementation efforts, as well as helps DHCS further its efforts to provide high-quality, equitable care.
BH-SAC is a broad-based body that disseminates information and receives coordinated input regarding DHCS behavioral health activities. It was created as part of the ongoing DHCS effort to integrate behavioral health with the rest of the health care system and incorporates existing groups that have advised DHCS on behavioral health topics.
CalAIM 託管長期服務和支持（MLTSS）和雙重整合工作小組會議
On May 30 at 10 a.m., DHCS will host the CalAIM MLTSS and Duals Integration Workgroup virtual meeting (advance registration is required). The workgroup serves as a stakeholder collaboration hub for CalAIM MLTSS and integrated care for dual eligible members and allows stakeholders to provide feedback and share information about policy, operations, and strategy for upcoming changes to Medi-Cal and Medicare.
議程主題包括有關雙合資格特殊需要計劃（D-SNP）州醫療補助機構合同（SMAC）和政策指南的更新，雙合資格會員的醫療保險註冊數據，默認註冊試點和 2025 年聯邦醫療保險中心 & Medicaid 服務（CMS）聯邦醫療保險優勢和 D 部最終規則的更新，以及對雙合資格會員提供的增強護理管理和社區支持的簡報。
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。 如有任何問題或意見，請電子郵件 info@calduals.org。