DHCS Stakeholder News - August 26, 2022
The Department of Health Care Services (DHCS) is providing this update of significant developments regarding DHCS programs.
Top News
Medi-Cal Managed Care Procurement Update
On August 25, DHCS issued Notices of Intent to Award (NOIAs) for Medi-Cal managed care plan (MCP) contracts to provide services to members beginning on January 1, 2024. DHCS intends to award 28 contracts to the following MCPs to deliver Medi-Cal services in 21 counties, as listed below:
| Intended Awardees | Counties |
| Molina Health Care | Los Angeles, Riverside, San Bernardino, Sacramento, San Diego |
| Anthem Blue Cross Partnership Plan | Alpine, Amador, Calaveras, El Dorado, Fresno, Inyo, Kern, Kings, Madera, Mono, Santa Clara, San Francisco, Sacramento, Tuolumne |
| Health Net | Amador, Calaveras, Inyo, Mono, San Diego, San Joaquin, Stanislaus, Tulare, Tuolumne |
The state is raising expectations of plans in the Medi-Cal program. The restructured and more robust managed care contract will hold MCP partners and their subcontractors more accountable for:
- High-quality, accessible, and comprehensive care across all settings and levels of care,
- Reducing health disparities,
- Improving health outcomes, and
- Transparency by making available information and insights to support plan choice.
While the procurement only applies to commercial MCPs, the new contracts will apply to all MCPs, including County Organized Health Systems, Local Initiatives, the new Single Plan Model, and Kaiser, starting in 2024. For additional information about the MCP procurement and contract, please visit the
DHCS website.
County COVID-19 Public Health Emergency (PHE) Unwinding Readiness Toolkit
On August 26, DHCS released a county
COVID-19 PHE unwinding readiness toolkit and corresponding Medi-Cal Eligibility Division Information Letter to counties. Counties are encouraged to use the county readiness checklist and recommended strategies to prepare for COVID-19 PHE unwinding activities and the resumption of normal Medi-Cal operations. Counties are required to use the county COVID-19 PHE readiness plan template to document their PHE unwinding operations plan, which counties must submit to DHCS no later than 10 days before the end of the PHE. DHCS will present the toolkit to counties in September as part of the monthly county engagement meetings.
Program Updates
PATH Collaborative Planning and Implementation Initiative Participant Registration
DHCS is launching regional collaborative planning groups to help identify and resolve local CalAIM implementation issues and inform how funding initiatives can support program implementation to ultimately improve population health. These groups will be comprised of individuals representing MCPs, providers, health sector community-based organizations, city and county agencies, public hospitals, Medi-Cal Tribal and Designees of Indian Health Programs, and others.
On August 22, DHCS launched a participant registration form for the Providing Access and Transforming Health (PATH) Collaborative Planning and Implementation initiative. Eligible entities can register now to participate in a collaborative planning group in their region. Please email collaborative@ca-path.com with any questions about the participant registration process.
Hospital and Skilled Nursing Facility COVID-19 Worker Retention Payments
DHCS posted an initial set of
SNF Frequently Asked Questions (FAQs) and
Glossary of Terms on the
Hospital and Skilled Nursing Facility COVID-19 Worker Retention Payments webpage. The FAQs will be updated regularly, and information about the application submission process will be released in the coming weeks. For the latest updates and program information, please refer to this
webpage or submit questions to
wrp@dhcs.ca.gov.
Medi-Cal Rx Implementation Update
On August 16, DHCS published a
bulletin announcing the next step of the Medi-Cal Rx Claim Edit and Prior Authorization (PA) Reinstatement effort. Beginning on September 16, PAs requirements will be reinstated for 11 drug classes for new start (first time) medications for beneficiaries 22 years of age and older. Additionally, DHCS determined that prescriptions for new start medications within the 11 drug classes for beneficiaries 21 years of age and under will be excluded from PA reinstatement. DHCS recognizes that providers of specialty pediatric services have been significantly impacted by the transition to Medi-Cal Rx, and exclusion of this population from this wave prevents additional administrative obligation by providers at this time.
Furthermore, monthly updates to the Contract Drugs List will take effect on September 1, which will allow Medi-Cal Rx to assess the impact of prior waves and identify opportunities to improve provider awareness via communication and coordination. A 15-day bulletin will be sent on September 1, and stakeholders are encouraged to continue submitting comments and feedback on the PA reinstatement to
Reinstatement@dhcs.ca.gov.
Published COVID-19 Information
Upcoming Stakeholder Meetings and Webinars
CYBHI Monthly Public Webinar
On August 29 at 3 p.m., DHCS will virtually host a public webinar on DHCS' progress in implementing various work streams for the Children and Youth Behavioral Health Initiative (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.
Advance registration is required.
Hearing Aid Coverage for Children Program (HACCP) Meeting
On August 31 at 3 p.m., DHCS will host a virtual ad hoc HACCP stakeholder meeting to share program updates and information on new and upcoming work efforts. Additional information is available via the
Hearing Aid Coverage for Children Program webpage.
CalAIM Webinar: ECM Long-Term Care Populations of Focus
On September 8 at 1:30 p.m., DHCS will host a webinar on CalAIM ECM Long-Term Care Populations of Focus. Advance registration is required. Participants are invited to submit questions by September 5 to CalAIMECMILOS@dhcs.ca.gov. Attendees will also have an opportunity to ask questions during the session.
