熱門新聞​​  

加州提交申請擴大鐮狀細胞疾病治療​​  

On March 11, DHCS applied to CMS to participate in the groundbreaking Cell and Gene Therapy (CGT) Access Model. If accepted, DHCS will implement this multi-year initiative to expand Medi-Cal members’ access to innovative and potentially life-changing therapies for sickle cell disease (SCD), a severe genetic blood disorder that disproportionately impacts people of African descent. Gene therapy represents a groundbreaking approach to SCD. However, these therapies come with extraordinary costs, making access difficult for patients and Medicaid programs, including Medi-Cal. The CGT Access Model addresses this challenge by using a negotiated rebate system that ties payments for these treatments to patient outcomes. If the therapy does not meet expected health improvements, drug manufacturers will provide rebates to Medicaid programs, helping ensure financial sustainability while expanding access to care. If California is approved, eligible Medi-Cal members would gain access to gene therapy treatment, fertility preservation services, case management, travel assistance, and behavioral health support. CMS anticipates testing the model over an 11-year performance period. If approved, California will begin participating in this model on July 1, 2025. 
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傳統醫療保健實踐福利實施​​  

On March 21, DHCS published Behavioral Health Information Notice (BHIN) 25-007 – Traditional Health Care Practices Benefit Implementation. This policy, the result of years of dedicated effort and advocacy from California Tribal leaders and partners, provides guidance on the implementation of the traditional health care practices benefit in the Drug Med-Cal Organized Delivery System (DMC-ODS). The federal Centers for Medicare & Medicaid Services (CMS) approved DHCS to cover traditional health care practices provided by Indian Health Care Providers (IHCP) for Medi-Cal members in DMC-ODS counties through December 31, 2026, unless extended or amended. Traditional health care practices encompass two new service types: Traditional Healer and Natural Helper services. DMC-ODS counties will cover Traditional Healer and Natural Helper services provided by IHCPs to Medi-Cal members who meet DMC-ODS access criteria. For questions about traditional health care practices or this BHIN, please email traditionalhealing@dhcs.ca.gov.​​  

Additionally, on April 22, DHCS will present an overview of BHIN 25-007 at the Tribes and Indian Health Program Representatives meeting (advance registration required). The presentation is open to the public and will review policy guidance to support IHCPs and DMC-ODS 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.” 
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專案更新​​ 

現已上載：關閉循環推薦實施指南的網絡研討會材料​​  

Effective July 1, 2025, Medi-Cal managed care plans will be required to implement Closed-Loop Referral (CLR) requirements for Enhanced Care Management (ECM) and Community Supports. CLR requirements aim to increase the number of Medi-Cal members successfully connected to these benefits and services. By improving information collection processes, managed care plans will be able to better support individual referrals and address system-level gaps in referral practices and service availability that impact members. DHCS released materials from the February 13 webinar (posted under Informational Webinars) to share more details about these requirements. In the webinar, DHCS provided:​​  

• The Department’s goal and motivation for releasing new CLR requirements.​​ 
• CLR 要求如何通過簡化推薦跟踪，支持和監控工作來改善會員推薦過程。​​  
• 關於 CLR 要求如何幫助成員獲得醫療量身定制的膳食社區支持的示例使用案例情況。​​  

如有關加州推進和創新的 Medi-Cal（CalAIM）人口健康管理計劃的任何疑問或意見，請聯繫 DHCS，請通過 PHMSection@dhcs.ca.gov 聯繫。
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加入我們的團隊​​ 

DHCS 正在為其財務、人力資源、藥房、行為健康及其他團隊進行招聘。如需詳細資訊，請造訪 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。
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報導大使網路研討會​​  

加州太平洋標準時間 3 月 25 日上午 11 點至中午 12 點，DHCS 將舉辦承保大使網路研討會（需提前註冊），提供有關醫療保健選擇和 Medi-Cal 更新的資訊。承保大使協助傳播有關 Medi-Cal 福利、投保資訊及專注於為所有人創造健康加州的新專案的資訊。請造訪Coverage Ambassador網站瞭解更多資訊，或訂閱成為 Coverage Ambassador 並定期收到最新資訊。
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託管長期服務和支持（MLTSS）和雙重整合工作小組會議​​  

On March 27, from 10 a.m. to 12 p.m. PDT, DHCS will host the CalAIM MLTSS and Duals Integration Workgroup meeting (advance registration required). The workgroup is a stakeholder collaboration hub for CalAIM MLTSS and integrated care for dual eligible members. It allows stakeholders to provide feedback and share information about policy, operations, and strategy for upcoming changes to Medi-Cal and Medicare. The meeting agenda includes updates on Medicare enrollment data for dual eligible members, the Dual Eligible Special Needs Plan (D-SNP) Dashboard, D-SNP initiatives, and the D-SNP State Medicaid Agency Contract and Policy Guide. It also includes data updates on Enhanced Care Management and Community Supports for dual eligibles and a Community Supports service spotlight presentation on select service definition updates.​​  

More information, background materials, transcripts, and video recordings of previous workgroup meetings are posted on the CalAIM MLTSS and Duals Integration Workgroup webpage. For questions or comments, please email DHCS at info@calduals.org.  
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兒童助聽器覆蓋專案 (HACCP) 醫療服務提供者和聽力專業人員的網路研討會​​  

On March 27, from 12 to 1 p.m. PDT, DHCS will host the quarterly HACCP webinar for medical providers and hearing professionals. For more information and to register, please visit DHCS’ HACCP webpage. Registration information will be posted as the webinar date approaches. 
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如果你錯過了​​ 

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。
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