DHCS 利益相關者更新-8 月 25, 2023
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卡拉艾姆示範修正案批准
On August 23, the Centers for Medicare & Medicaid Services (CMS) approved an amendment to the California Advancing and Innovating Medi-Cal (CalAIM) Section 1115 demonstration waiver, allowing the state to implement county-based model changes in its Medi-Cal managed care program. The amendment includes expenditure authority to limit the choice of managed care plans (MCPs) in non-rural areas. This authority would apply in the metro, large metro, and urban counties intending to participate in the County Organized Health System (COHS) or Single Plan models.
For rural counties, CMS approved an amendment to the CalAIM Section 1915(b) waiver on June 26 to limit plan choice in rural counties to participate either in the COHS or Single Plan models. These county-based model changes will go into effect on January 1, 2024. Twelve counties will become COHS and three will become Single Plan model counties. For more information about all counties, their current and 2024 model type, and the MCPs operating in the county, please see the MCP county table.
專案更新
加州醫療補助健康保健計劃 Rx
8 月 22 日，Medi-Cal Rx 客戶服務中心為會員、處方藥師、藥劑師和公眾實施了互動語音識別增強功能。增強功能包括通話調查、簡化通話的主選單、告知座席有關通話原因的代碼、迴圈至主選單以便通話者可檢查多項自助服務項目，以及改進提示語言和位置。
On August 16, a New Start PA Reminder Alert was published about the prior authorization requirements that will be reinstated beginning on September 22 for new start enteral nutrition products for members 22 years of age and older.
Medi-Cal for Kids& 青少年資訊郵件
On August 25, DHCS distributed an informational mailing to Medi-Cal fee-for-service (FFS) members and/or their parents or guardians about the federal Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services, known in California as Medi-Cal for Kids & Teens. The FFS mailing includes: (1) Medi-Cal for Kids & Teens brochures to improve member understanding of how Medi-Cal works for children, teens, and young adults, what it covers, and its role in preventive care screening, diagnosis, and treatment. The child brochure is for children up to age 12, and the teen brochure is for ages 12-20; and (2) “Medi-Cal for Kids & Teens: Your Medi-Cal Rights” guide to help members under age 21 understand their Medi-Cal benefits and their recourse if medically necessary care is denied, delayed, reduced, or stopped. The materials, including translations, are posted on the Medi-Cal for Kids & Teens webpage.
加入我們的團隊
DHCS 正在招聘我們的財政、人力資源、法律、審計、健康政策和資訊科技團隊。 有關更多信息，請訪問 CalCareers 網站。
DHCS is dedicated to providing equitable access to quality health care, leading to a healthy California for all. DHCS’ goals and objectives express the tremendous work DHCS is leading to transform our health care system and reflect the organizational culture we are building together.
即將舉行的利害關係人會議和網絡
將創傷知識的實踐整合到生殖健康服務網絡研討會
8 月 30 日中午 12 點至下午 1 點 30 分，DHCS 和加州預防訓練中心將舉辦「將創傷知識實踐融入生殖健康服務」網路研討會。創傷知情照護承認需要瞭解客戶的生活經驗才能提供有效的照護，並有可能改善病患的參與程度、治療依從性和健康結果。對於無法參加現場網路研討會的人士，可在Family PACT 網站上取得網路研討會的謄本和錄音，以及其他資源。
印度健康計劃部落和指定人員季度網絡研討會
On August 30, from 2 to 3 p.m., DHCS will host a webinar (advance registration required) for tribal and Indian health program representatives to provide feedback on DHCS initiatives with specific impact to tribes, Indian health programs, and American Indian Medi-Cal members. The webinar will provide information about State Plan Amendments, waivers, and demonstrations proposed for submission to CMS, including the Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) Medicaid section 1115 demonstration and transitional rent services amendment to the CalAIM section 1115 demonstration. Email questions or comments to TribalAffairs@dhcs.ca.gov.
股權與實務轉型付款計劃網路研討會
On August 30, from 3 to 4 p.m., DHCS will host an Equity and Practice Transformation Payments Program Webinar (advance registration required) to share an update on the Equity and Practice Transformation Payments Program, which is a one-time $700 million primary care practice transformation program initiative to advance health equity and population health and invest in upstream care models. Details about the Provider Directed Payment Program will be discussed during the webinar; the program application and other materials will be posted on the DHCS website in the future. Please email ept@dhcs.ca.gov with any questions.
DHCS 覆蓋大使：培訓練培訓師網絡研討會
On August 31, from 10 to 11:30 a.m., DHCS will host a webinar on Coverage Ambassadors: Train the Trainer. The webinar will serve as a training session for Coverage Ambassadors to better assist their communities as California resumes standard Medi-Cal operations and communicates the importance of members renewing their Medi-Cal coverage. The webinar will also describe the resources available and how to use them. For more information, visit the Coverage Ambassadors Coverage Ambassadors webpage. Join the Coverage Ambassadors mailing list to receive the latest information and updated toolkits as they become available.
護理設施融資改革網絡研討會
On September 7, from 2 to 3 p.m., DHCS will host a virtual stakeholder webinar to discuss the development of the Skilled Nursing Facility Workforce Standards Program and provide updates on other nursing facility financing reform programs authorized by Assembly Bill 186 (Chapter 46, Statutes of 2022). Stakeholder input will be accepted. Additional information is available on the Nursing Facility Financing Reform (AB 186) webpage.
兒童助聽器保障計劃（HACCP）家庭和社區合作夥伴網絡研討會
On September 12, from 11 a.m. to 12 p.m., DHCS will host a HACCP webinar to share guidance with families and communities about applying for hearing aid coverage and helping children to maximizing their HACCP benefits once enrolled. DHCS welcomes newly interested families, those who are currently participating in HACCP, and community partners supporting families and children to join this webinar for program updates, tips, and a Q&A session. For more information, please visit www.dhcs.ca.gov/haccp.
杜拉實施工作小組會議
9 月 14 日中午 12 點至下午 2 點，DHCS 將舉行第三次 Doula 實施工作組會議。聆聽會議的連結將於 8 月 31 日前張貼在 Doula 服務作為 Medi-Cal 福利的網頁上。會議內容包括報告 DHCS 的分娩照護路徑提案和婦女導師的角色，以及規劃未來的會議。該工作組負責審查如何透過教育外展計畫增加婦女陪護服務的可用性、識別並盡量減少婦女陪護服務的障礙，以及解決婦女陪護和會員付款和補償延遲的問題。
醫療提供者和聽力專業人員網絡研討會
On September 14, from 12 to 1 p.m., DHCS will host a HACCP webinar to share information with providers to help pediatric patients and their families maximize HACCP benefits. The training session will address program requirements for families to apply for coverage and the claims submission process for audiologists, otolaryngologists, physicians, and their office staff. For more information, please visit www.dhcs.ca.gov/haccp.
如果你錯過了
加州擴大監獄和毒品法院接受阿片類藥物治療的機會
On August 22, DHCS announced it will expand Medication Assisted Treatment (MAT) to jails and drug courts it will expand Medication Assisted Treatment (MAT) to jails and drug courts. The $2.9 million in funding will go to 29 counties to support the development or expansion of access to MAT. By bringing county teams together in a learning collaborative, county agencies and providers serving justice-involved residents can more effectively coordinate and further build system capacity to ensure access to effective treatment and recovery supports. This expansion will better serve residents in need, and MAT, specifically, has been shown to reduce criminal activity and reincarceration to better serve the entire community.
州擴展卡爾霍普學校倡議合作夥伴關係
On August 24, DHCS announced the extension of the CalHOPE Schools Initiative through June 30, 2024 the extension of the CalHOPE Schools Initiative through June 30, 2024. The initiative provides free resources for school personnel, youth, and parents surrounding three powerful films that address student social-emotional and mental health needs: A Trusted Space: Redirecting Grief to Growth, Angst: Building Resilience, and Stories of Hope Shorts.
國會議院周刊關於美國加州重新定義的意見
8 月 20 日，Capitol Weekly 刊登了 LA Care 執行長 John Baackes 的意見。LA Care 是洛杉磯縣的 Medi-Cal 管理性護理計劃之一。Baackes 呼籲「我們所有人 - 鄰居、政府合作夥伴和社區倡導者 - 盡我們所能，讓我們的朋友和鄰居繼續獲得 Medi-Cal 保險」。
當您與 Medi-Cal 會員互動時，請與他們分享保持其承保的有用提示。如果他們的資格更新日期是在六月或七月，還不算太晚。他們可以在今天將 Medi-Cal 更新資料交回當地縣府辦公室，以便將其承保恢復至原來的更新日期。此外，如果 Medi-Cal 會員在過去幾年搬家或聯絡資料有變更，他們應確保當地的縣辦公室有他們的最新資料，以便可聯絡到他們提供重要的續保資訊。如果會員收到郵寄來的 Medi-Cal 續保文件包（黃色信封），他們必須迅速行動，交回續保文件，以維持自己及家人的承保。