Help the California School-Based Health Alliance Set Their 2018 Policy Priorities

The California School-Based Health Alliance (CSHA), a statewide nonprofit which aims to improve health and academic success of children and youth by advancing health services in schools, is setting their policy priorities for 2018 and inviting CSHA members to provide feedback during a call on September 20, 2017. Over the past several years, CSHA has worked to advance several issues impacting...

DHCS Issues Clarification on Coordination of Care with Managed Care Plans

California's Department of Health Care Services (DHCS) has issued clarification on a previous email regarding protocols for LEAs coordinating care with Managed Care Plans (MCPs). The original email, sent on August 9, had raised questions about what appeared to be new coordination requirements. In a clarification email sent on August 18, DHCS underscored that there is no new policy and their...

Advisory Panel Finalizing School Health Recommendations to DHCS

The Medi-Cal Children's Health Advisory Panel (MCHAP) will be meeting on April 18, 2017 to finalize their recommendations to the Department of Health Care Services (DHCS) on children's behavioral health care, including strengthening school-based health services through the SMAA and LEA programs. The most recent draft of MCHAP's recommendations call on DHCS to work more collaboratively with...

RMTS for LEA Billing — Implementation Advisory Group Publishes January Meeting Summary

The Implementation Advisory Group (IAG) has published minutes from their January 31, 2017 meeting, and discussed the following topics: DHCS presented a draft chart that identified LEA services that are proposed under SPA 15-021. The chart covered IEP/IFSP services, non-IEP services covered under “plans of care” and other non-IEP services that are outside of a plan of care (e.g., first...

Rule Proposed on Providing Mental Health ‘Parity’ in Medicaid Program

A federal law that passed in 2008 was supposed to ensure that when patients had insurance benefits for mental health and addiction treatment, the coverage was on par with what they received for medical and surgical care. But until now, the government had only spelled out how the law applied to commercial plans. That changed Monday, when federal officials released a long-awaited rule proposing...

Health Agency Opposes Bill to Create Children’s Medi-Cal Advisory Panel

State health officials have logged official opposition to a bill designed to create an advisory committee on Medi-Cal children's issues. In a letter last week to the bill's author, officials from the Department of Health Care Services said they were taking a stand against a legislative proposal to transform the Healthy Families Advisory Board into the Medi-Cal Children's Health Advisory Panel. ...

CMS Releases Series of EPSDT Briefs, Addresses Medical Necessity Issues

Last week CMS published three new guides focused on Medicaid's Early and Periodic Screening, Diagnosis and Treatment (EPSDT) benefit. Over the past many years states as well as providers, patients and their families have raised questions about various aspects of EPSDT. The guides are intended to assist states in complying with CMS' interpretation of the EPSDT statute and regulations. The...

Signs Point to Adding Autism Coverage for Kids Under Medi-Cal Managed Care

The state has been considering the addition of autism therapy as a Medi-Cal benefit based on legal developments in other states, according to state officials at a budget subcommittee hearing this week. "We believe it's reasonable for the Legislature to consider adding ABA therapy services to Medi-Cal managed care [and making that] a high priority," said Ross Brown, a fiscal and policy analyst...

Healthy Families Transition Concerns Highlighted as Most Difficult Phases Start

The third phase of the Healthy Families transition begins today, and it could be a bumpy passage. The first two phases moving about 615,000 Healthy Families children to Medi-Cal managed care plans have gone relatively smoothly, with almost all of those children retaining their health plan and roughly 94% of them retaining their primary care physician, according to the Department of Health Care...

DHCS Updates Healthy Families Program Transition to Medi-Cal FAQs and Network Adequacy Reports for Phases 3 & 4

The California Department of Health Care Services (DHCS) has provided new and updated Frequently Asked Questions (FAQs) and Network Adequacy Assessments to their website regarding the ongoing transition of Healthy Families Program beneficiaries to Medi-Cal. Posted FAQs address several service and care questions and are categorized by audience type and issue (for example: mental health...