DHCS Stakeholder News Update - April 15, 2022
Dear Stakeholders,
The Department of Health Care Services (DHCS) is providing this update of significant developments regarding DHCS programs, as well as guidance related to the COVID-19 public health emergency (PHE).
Older Adult Expansion Webpage Update
To support the implementation of the Medi-Cal Older Adult Expansion, effective May 1, 2022, DHCS recently created an Older Adult Expansion webpage that includes the following information:
- A PowerPoint presentation of the Older Adult Expansion roadmap.
- Frequently Asked Questions.
- First notice mailed to eligible beneficiaries regarding the expansion of their benefits.
DHCS also created a companion webpage that is translated to Spanish. Individuals can access the Spanish version of the webpage by clicking on the En Español link at the top of the Older Adult Expansion webpage. The page can also be translated to numerous languages by either selecting the globe with the word “translate" in the top right corner of the webpage, or by scrolling to the bottom of the webpage and selecting the appropriate threshold language.
Information and resources posted on these pages will continue to be updated.
FQHC, RHC, and Tribal FQHC Claims for COVID-19 Vaccine Administration
Federally Qualified Health Centers (FQHC), Rural Health Centers (RHC), and Tribal FQHC providers may receive reimbursement for COVID-19 vaccine administration during vaccine-only encounters, retroactive to November 2, 2020. Vaccine-only encounters are visits when the administration of the COVID-19 vaccine does not otherwise meet the criteria for a qualifying office visit. They are not reimbursable at the Prospective Payment System (PPS) rate for FQHC/RHC providers, nor the Alternative Payment Methodology (APM) for Tribal FQHC providers. FQHC, RHC, and Tribal FQHC providers may receive reimbursement up to a maximum allowable rate of $67 for each COVID-19 vaccine administered during a vaccine-only encounter.
For COVID-19 vaccines that were administered during a qualifying office visit, FQHC, RHC, and Tribal FQHC providers are entitled to reimbursement at their individual PPS/APM rates. Providers are reminded that each administration of the COVID-19 vaccine either falls under either a qualifying office visit or a vaccine-only encounter, not both.
Additional information is posted on the Medi-Cal Providers website.
California Advancing and Innovating Medi-Cal (CalAIM) Data Sharing Authorization Guidance
DHCS recently released final CalAIM Data Sharing Authorization Guidance. This document provides guidance that supports data sharing between CalAIM participants. The guidance clarifies requirements and allowances in the Budget Trailer Bill, Welfare and Institutions Code, and Penal Code. It also provides data sharing use cases to assist stakeholders in understanding circumstances in which personal information may be disclosed under CalAIM.
CalAIM Population Health Management (PHM) Advisory Group – April Meeting
On April 26, DHCS will host the second meeting of the PHM Advisory Group from 10:30 a.m. to 12 p.m. PDT. DHCS established the PHM Advisory Group to provide input to support the design and implementation of the PHM Program and Service. Members, which include representatives from health plans, providers, counties, state departments, consumer organizations, and other groups, will participate in Advisory Group meetings and provide real-time feedback and recommendations. The meetings are open to the public, and meeting information and materials will be available on the DHCS website.
Stakeholders are encouraged to submit questions in advance of the webinar to CalAIM@dhcs.ca.gov. Advance registration is required.
Providing Access and Transforming Health (PATH) Funding for the CalAIM Justice-Involved Initiative
On April 15, DHCS released a draft guidance memo for Round 1 of the Providing Access and Transforming Health (PATH) Justice-Involved Capacity Building Program. This draft guidance provides additional information regarding the eligibility criteria, application process, and funding methodology.
PATH is a $1.44 billion program approved under CalAIM. It provides transitional funding to invest in providers, counties, community-based organizations, and other partners to support the state's efforts to maintain, build, and scale the capacity necessary to support and implement key initiatives under CalAIM.
California received expenditure authority to support implementation of the statewide justice-involved initiative. Funding for the PATH Justice-Involved Capacity Building Program will support collaborative planning as well as information technology (IT) system modifications necessary to implement pre-release Medi-Cal application and suspension processes. This program will provide $151 million in funding, made available in two rounds, to correctional agencies, correctional institutions, and county social service departments:
Round 1: A planning grant funding opportunity will provide grants (ranging from $50,000 to $400,000) to correctional agencies (or a county agency applying on behalf of a correctional agency) to support collaborative planning with county departments of social services and other enrollment implementation partners to identify processes, protocols, and IT modifications that are necessary to support implementation of pre-release enrollment and suspension processes.
Round 2: An implementation grant funding opportunity will provide application-based grants (range to be determined) to support correctional agencies and county departments of social services as they implement the processes, protocols, and IT system modifications that were identified during the Round 1 planning phase. While entities do not need to participate in Round 1 in order to apply for Round 2 funding, the Round 1 planning grant funds offer an opportunity to support the development of a comprehensive application for Round 2 funding.
DHCS intends to release the final Round 1 application template in early May. Eligible entities will be able to apply for Round 1 funding from the time the application template is released until July 31. DHCS intends to distribute Round 1 funding as soon as June 1.
For questions or comments, please email CalAIMJusticePreReleaseApps@dhcs.ca.gov. For additional information, please visit the DHCS website.
U.S. Department of Health and Human Services (HHS) Renews PHE
On April 12, HHS renewed the COVID-19 PHE for a full 90-day extension, effective April 16 through July 15. The formal PHE declaration was posted on the HHS website.
Published COVID-19 Information
Additional updates will be posted on the DHCS COVID-19 Response page.
Medi-Cal and COVID-19 Frequently Asked Questions
