DHCS Stakeholder News – August 12, 2022
尊敬的利益相關者，
衛生護理服務部（DHCS）正在提供有關 DHCS 計劃的重要發展的更新。
熱門新聞
DHCS 向聯邦合作夥伴發出要求索取猴桃花指引
On August 12, DHCS sent a letter to the Centers for Medicare & Medicaid Services (CMS) requesting immediate guidance for establishing a Medicare rate for the monkeypox vaccine administration.
In an effort to be responsive to our Medi-Cal beneficiaries and providers, California will submit a Disaster State Plan Amendment to seek federal approval to reimburse vaccine administration and applicable laboratory testing at 100 percent of the Medicare rate, once established. As part of this request, DHCS will seek federal approval to reimburse Federally Qualified Health Centers, and similarly situated clinics that are paid an all-inclusive rate, the vaccine administration fee for vaccine-only visits, consistent with how DHCS is reimbursing for COVID-19 vaccine-only visits. The requested federal approvals will also include reimbursement for vaccine administration performed by non-clinic providers.
Additionally, please see the Centers for Disease Control and Prevention’s Reducing Stigma in Monkeypox Communication and Community Engagement and the California Department of Public Health’s toolkit messaging for sharing broadly among your networks.
中卡保費退款
參議院條例草案 184（2022 年全巴衛生條例草案）授權 DHCS 將 Medi-Cal 計劃的保費降低到零。 由 1, 2022 年 7 月起，註冊以下計劃的會員不再需要支付保費，作為資格的要求：
- Optional Targeted Low Income Children’s Program
- 中等收入無保險孕婦醫療照護專案（Medi-Cal Access Program）
- 醫療服務嬰兒服務計劃
- County Children’s Health Initiative Program
- 250% 工作殘疾人計劃
DHCS released policy guidance via All County Welfare Directors Letter #22-14 and Medi-Cal Eligibility Division Information Letter #I 22-25, and is seeking federal authority to implement this policy through SPA 22-0042 and SPA 22-0034, which are pending CMS approval. Furthermore, DHCS has begun the process of issuing refunds to Medi-Cal and Children’s Health Insurance Program (CHIP) beneficiaries who overpaid their premiums as of July 1.
U.S. Surgeon General’s Comments on the Children and Youth Behavioral Health Initiative (CYBHI)
In a recent SAGE Journals article, U.S. Surgeon General Dr. Vivek H. Murthy highlighted the work that is underway through the CYBHI. The article serves as a call to action for the nation, with a stark reminder of what’s at stake in ensuring that children and youth receive the help they need when and where they need it, especially those in our most underserved communities.
The CYBHI, which includes multiple work streams that are led by five departments and offices within the California Health & Human Services Agency (CalHHS) – DHCS, Department of Health Care Access and Information, Department of Managed Health Care, California Department of Public Health, and the Office of the California Surgeon General – focuses on promoting mental, emotional, and behavioral well-being by preventing challenges and providing services, support, and routine screening for all children and youth for emerging and existing needs.
專案更新
為加州老年人提供的醫療外展和註冊援助
DHCS 正在為有潛在資格獲得 Medi-Cal 健康保障的 28,000 名老年人提供外展和註冊援助。 DHCS 向加利福尼亞州縣協會和加州保障 & 健康倡議（CCHI）向加利福尼亞州州縣協會（CCHI）提供 24 萬美元，以合作在 30 2024 的入學援助工作。 工作的目標是：
- 65 歲及以上的雙重合資格受益人或受益人，並待中的 Medi-Cal 資格重新確定。
- 65 歲及以上已註冊 Medi-Cal 並需要協助確定醫療保險資格的人士。
- 65 歲或以上或殘疾人士，符合 Medi-Cal 資格，但目前尚未註冊，包括符合資格參加聯邦醫療保險儲蓄計劃的人士。
- 由於 Medi-Cal 擴展至 50 歲及以上的成年人，無論移民身份如何，因此新有資格獲得 Medi-Cal 的個人。
- 65 歲的 Medi-Cal 受益人尚未註冊聯邦醫療保險，這取決於與該縣的一或多個 Medi-Cal 託管護理計劃（MCP）簽訂協議。
CCHI 將獲得具有多年經驗為 Medi-Cal 受益人提供外展和註冊援助的社區組織協助，以確保符合 Medi-Cal 資格的人提供更多醫療服務的機構，以改善成果並減少健康差異。 有關更多信息，請訪問美國加州老年人的外展和註冊網頁。
CHIP 註冊和重新決定政策更新
On August 3, CMS approved DHCS’ State Plan Amendment (SPA) CA-22-0035 submission, allowing DHCS to implement provisions for temporary adjustments to enrollment and redetermination policies. Effective July 1, 2022, DHCS is able to use a regulatory timeliness exception for the timely processing of CHIP applications and renewals for children in families living and/or working in state- or federally-declared disaster areas.
通過這個 SPA，加利福尼亞州正進行技術更改，以使其通過 SPA CA-17-0043 批准的災難救援條文與 2022 年 3 月發布的更新的災難救援 SPA 模板一致。 這些 SPA 條文可以通知 CMS 條文的有效日期和受災害影響的地區，通過通知 CMS 在未來的州或聯邦宣告的災難期間實施。
流動危機服務資訊要求 (RFI) 發布
On August 8, DHCS released a RFI for the mobile crisis services benefit. The RFI invites vendors to provide DHCS with information to support training for and implementation of mobile crisis services. DHCS intends to submit a SPA to add qualifying community-based mobile crisis intervention services as a new Medi-Cal benefit, effective no sooner than January 2023. Implementing mobile crisis services is an integral part of California’s broader efforts to strengthen the continuum of community-based care for Medi-Cal beneficiaries who are experiencing a mental health or substance use disorder crisis.
DHCS 正在開發 Medi-Cal 移動危機服務福利，其中將包括與培訓、準備性審查和技術協助相關的材料和指導。
醫院和技術護理設施 COVID-19 勞工留住付款計劃
DHCS 正在提供有關此計劃的記錄日期和最終提交日期的最新指導：
- 根據記錄日期，符合條件的僱員必須在 11 月 28, 2022 之前由受保實體或受保服務僱主在合格設施僱用，才能獲得保留補助金。
- 為截止提交日期，涵蓋實體和受保服務僱主必須於 30 2022 十二月下午五時提交其申請，包括合資格僱員名單。
在未來幾週內，DHCS 將通過每週利益相關者公告以及醫院和技術護理設施 COVID-19 勞工保留付款網頁提供有關提交流程和一般更新的額外指導。
兒童助聽器保障計劃（HACCP）更新
DHCS 擴大了輔助代碼 A1 的保障，包括與骨傳導助聽器（BCHD）相關的新 HACCP 福利，並於 2021 7 月 1 或之後的服務日期起生效。
For more information about HACCP coverage of BCHDs, please see the Medi-Cal Provider Newsflash. For information about the program more broadly, please see DHCS’ HACCP webpage, which was recently expanded to include additional resources for families and providers, including a secure chat option for communicating with the HACCP Call Center or uploading additional materials for an application that has already been submitted. Additionally, families seeking to apply for HACCP coverage may now submit their application electronically through the HACCP Online Application Portal.
醫用卡 Rx 實作更新
DHCS 和 Magellan (MMA) 進行了密集的計劃過程，以逐步恢復索賠編輯和事先授權 (PA) 要求。
- 第一階段，第一波，於 2022 七月 22 實施，以恢復國家處方藥計劃委員會（NCPDP）拒絕代碼 88 — 藥物使用審查 (DUR) 拒絕錯誤的 DUR 警報（例如藥物相互作用、高劑量、早期補充等）的索賠編輯。 恢復工作方法是逐步重複性的，密切關注利益相關者的準備和績效監控。 隨著時間的推移，它將根據數據分析，營運經驗和利益相關者反饋進行改進。
- 第一階段，第二波現已生效，專注於促進使用 CoverMyMeds（CMM）。
- Phase one, wave three is slated to begin on September 16 with the reinstatement of PA requirements for 11 drug classes for new start prescriptions for beneficiaries 22 years of age and older. Stakeholders are encouraged to continue submitting comments and feedback on the reinstatement approach via Reinstatement@dhcs.ca.gov.
社區衛生工作人員 (CHW) 水療中心批准
On July 26, DHCS received CMS approval for SPA 22-0001, which adds CHW as a preventive service. Developed in consultation with stakeholders, this SPA created CHW services as a Medi-Cal benefit, effective July 1, 2022, for both fee-for-service and managed care delivery systems. For more information about CHW services, including a link to the provider manual, please see the CHW webpage.
已發佈的 COVID-19 信息
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（CalAIM）豁免續約網絡研討會
On August 22 at 10 a.m., DHCS will virtually host a public hearing to receive stakeholder feedback on the proposed amendments to the CalAIM Section 1115 demonstration and Section 1915(b) waiver. Please register for this webinar in advance.
DHCS launched 30-day public comment and Tribal public comment periods on August 12. DHCS is seeking the CalAIM Section 1115 and 1915(b) amendment approvals from CMS to implement county-based model changes in the Medi-Cal Managed Care (MCMC) program. Through the Section 1915(b) waiver amendment, DHCS also plans to add or update language on policies or programs in the approved CalAIM 1915(b) waiver, including to reflect the MCMC model changes in select counties and direct contracts with the Kaiser Foundation Health Plan available for enrollment of certain Medi-Cal beneficiary populations in select counties. Additional information about the CalAIM Section 1115 demonstration application and Section 1915(b) overview are available on the CalAIM 1115 Demonstration & 1915(b) Waiver webpage. The 30-day public comment and Tribal public comment periods end on September 12.
與家庭 PACT 客戶討論有關 HPV 疫苗接種
On August 17, DHCS and the California Prevention Training Center will hold a webinar to provide information about the effectiveness and safety of the human papillomavirus (HPV) vaccine, review current Centers for Disease Control and Prevention recommendations for the use of the HPV vaccine, and provide advice on how to have effective shared decision-making conversations with clients about being immunized. Advance registration for PACT webinar is required. Effective July 1, 2022, the Family PACT program added HPV vaccination as a clinic benefit for individuals ages 19 through 45. For those unable to attend the live webinar, a transcript and recording of the webinar, along with additional resources, will be available on the Family PACT website.
Medi-Cal 牙科全州利益相關者會議
8 月 18 日上午 10 點，DHCS 將舉辦虛擬 Medi-Cal 牙科全州各州利益相關者會議。 本次會議的目的是為整個州的牙科利益相關者提供一個論壇，以分享有關 Medi-Cal Dental 計劃的反饋，並讓 DHCS 分享有關新和/或即將到來的工作工作的重要更新和信息。 更多信息可在 Medi-Cal 牙科全州利益相關者會議網頁上獲得。
DHCS 卡拉伊姆 MLTSS 和雙重整合工作小組會議
On August 18 at 10 a.m., DHCS will virtually host the CalAIM Managed Long-Term Services and Supports (MLTSS) and Duals Integration Workgroup meeting. Please register for the meeting, which is open to the public.
The meeting will serve as a stakeholder collaboration hub for CalAIM MLTSS and integrated care for dual eligible beneficiaries. It will also give stakeholders an opportunity to provide feedback and share information about policy, operations, and strategy for upcoming changes to Medicare and Medi-Cal. Agenda items include a summary of January 2023 enrollment changes; a presentation on the January 2023 transitions impacting dual eligible beneficiaries, including noticing, monitoring, and timelines; and an update on the Dementia Care Aware initiative.
Background materials, transcripts, and video recordings of the previous workgroup meetings, along with additional information about the workgroup, are posted on the CalAIM MLTSS and Duals Integration Workgroup webpage.
加利福尼亞州微笑醫療牙科服務活動
Smile, California is hosting Facebook Live presentations for Medi-Cal members in Spanish and English. The Spanish presentation will be held on August 24 at 1 p.m.; RSVP on Facebook. The English presentation will be held on August 26 at 1 p.m.; RSVP on Facebook. A Smile, California member outreach representative will deliver the Smile, your Medi-Cal benefits include dental! presentation, and a provider relations trainer will assist with answering audience questions.
為牙科提供者提供的 PAVE 門戶培訓
On August 24 at 11 a.m., DHCS will host a webinar introduction to PAVE for dental providers. Beginning on October 31, DHCS will implement the PAVE portal for dental providers, offering a new mode for submitting dental provider enrollment applications and required documentation to DHCS. This allows applicants to use the Medi-Cal Provider e-Form Application, as DHCS will no longer accept paper applications once PAVE is implemented. For more information about the webinar, including the registration link for the August 24 training, please view this Medi-Cal Dental Provider Bulletin. The PAVE demonstrations will be recorded and posted on the DHCS PAVE webpage.
DHCS 家庭計劃辦公室利益相關者會議
On August 24, DHCS will host a virtual family planning stakeholder meeting. The link to the meeting will be available on the Office of Family Planning webpage prior to the meeting.
杜拉福利益相關者會議
On August 24, DHCS will host a virtual stakeholder workgroup meeting about adding doula services as a covered Medi-Cal benefit. The meeting is open to the public. DHCS will engage with workgroup members on policy development details that will be reflected in the Medi-Cal provider manual and other policy guidance documents. All interested stakeholders may listen to the workgroup discussion regarding stakeholder feedback and provide input via email. DHCS will also share an update on the status of formal submission of the SPA to CMS. The link for the stakeholder meeting will be available on the doula webpage prior to the meeting.
CalAIM 網絡研討會：增強護理管理（ECM）和社區支持成員參與
On August 25 at 1:30 p.m., DHCS will host an all-comers webinar on CalAIM ECM and Community Supports member engagement. Topics for this session will include provider and member communications, referrals, outreach, and enrollment. This event is part of a series of technical assistance and informational sessions focused on supporting implementation of ECM and Community Supports. Throughout the series, DHCS leaders will be joined by presenters from MCPs, providers, and CBOs implementing CalAIM.
Advance registration for CalAIM webinar is required. Participants are invited to submit questions by August 22 to CalAIMECMILOS@dhcs.ca.gov. Attendees will also have the opportunity to ask questions during the webinar. An additional “Office Hours” event will be held on September 1 at 2 p.m. (see below) for attendees to ask any other questions not covered during the webinar.
CYBHI 每月網絡研討會
On August 29 at 3 p.m., DHCS will virtually host a webinar to keep stakeholders apprised of DHCS’ progress in implementing various work streams of the CYBHI. Key attendees include, but are not limited to, youth, parents, family members, behavioral health providers, Medi-Cal MCPs, county behavioral health departments, and commercial health plans, as well as education and other cross-sector partners. CYBHI Monthly Webinar advance registration is required.
CalAim 辦公時間：ECM 和社區支持會員參與
On September 1 at 2 p.m., DHCS will virtually host an “Office Hours” discussion on CalAIM ECM and Community Supports member engagement. As a follow-up to the August 25 webinar on this topic, this question and answer session will cover provider and member communications, referrals, outreach, and enrollment. This event is part of a series of “Office Hours” events focused on answering implementation questions from the field.
Advance registration is required. Participants are invited to submit questions by August 29 to CalAIMECMILOS@dhcs.ca.gov. Attendees will also have an opportunity to ask questions during the session.