With the recent Food and Drug Administration approval of COVID-19 vaccines, the Department of Health Care Services (DHCS) is seeking federal approval to help support delivery of the vaccine to all Medi-Cal beneficiaries.
Given the ongoing challenges associated with the COVID-19 public health emergency, the Department of Health Care Services (DHCS) has decided to delay the full implementation of Medi-Cal Rx until April 1, 2021.
CHA has issued a detailed summary, prepared by Health Policy Alternatives, of the Medicaid Managed Care final rule recently issued by the Centers for Medicare & Medicaid Services.
Earlier today, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that revises Medicaid Managed Care and Children’s Health Insurance Program regulations intended to reduce state administrative burden and increase program flexibility. CHA provided written comments on CMS’ proposed rule in January 2019.
In advance of the transition of pharmacy services to Medi-Cal Rx starting on Jan. 1, 2021, the Department of Health Care Services recently launched a training registration application on the Medi-Cal Rx portal for Medi-Cal prescribers and pharmacies.
CHA has developed for members a new infographic on the Hospital Fee Program, highlighting the expected changes between the 2017-19 Hospital Fee Program (V) and the 2019-21 Hospital Fee Program (VI). The infographic illustrates the shift in payment structure toward managed care “directed payments,” which requires a hospital to be a network provider to receive a payment.
CHA encourages members to participate in an upcoming meeting on the Governor’s Executive Order that would transition pharmacy services from Medi-Cal managed care plans into the fee-for-service delivery system by January 2021 — which will impact hospitals that participate in the 340B Drug Discount Program. The meeting will be held July 24 from 9:30-11:30 a.m. in Sacramento, and is designed to facilitate community awareness and provide a forum for stakeholder feedback.
Covered California announced today that the preliminary average rate change for the 2020 individual market will be 0.8% — lower than the actual average increase over the past five years (7.9%), and the lowest rate change since Covered California first began offering coverage in 2014.
The Department of Managed Health Care (DMHC) has released final guidance on its Knox-Keene licensure regulation, which applies to any contract entered into, amended, or renewed on or after July 1. The regulation, among other things, defines various types of risk and requires entities that assume any amount of global risk to either obtain a license under the Knox-Keene Health Care Service Plan Act of 1975 or receive an exemption from DMHC.