Health Care Access Forum
Health Care Access Forum – Thursday, May 25th
Forum Schedule:
9:15 AM – 10 AM Virtual Networking Breakout Rooms
10 AM – Noon Forum
Location: Virtual via Zoom ONLY
This is a members-only event. Register Below!
Need help registering? Please email Andrea at apalladino@hemophiliaca.org
Do you still need to renew your 2023 membership? Need extra tickets?
We have options for membership or to purchase extra tickets.
Questions? Email Andrea at apalladino@hemophiliaca.org.
30-Day Countdown – Phase III, Lift 4: Retirement of the Transition Policy for Beneficiaries 22 Years of Age and Older
May 23, 2023
On June 23, 2023, Phase III, Lift 4 (P3/L4) will be implemented, lifting the Transition Policy for 46 Standard Therapeutic Classes (STCs). This is the fourth in a series of lifts to retire the Transition Policy by lifting the override of NCPDP Reject Code 75 – Prior Authorization Required.
Click here to read which 46 STCs will be impacted with implementation of P3/L4 on June 23, 2023.
Discontinuation of the COVID-19 Uninsured Group Program
May 1, 2023
On February 9, 2023, the States received a 90 day notice from the Federal Government that the federal Coronavirus 2019 (COVID-19) Public Health Emergency (PHE) will end on May 11, 2023. Therefore, California’s COVID-19 Uninsured Group (UIG) program will end on May 31, 2023.
• The COVID-19 UIG program ends May 31, 2023.
• The COVID-19 UIG Application Portal will be decommissioned effective June 1, 2023. Access to the COVID-19 UIG Application Portal will be decommissioned effective June 1, 2023.
Click here for more information about the end of the Uninsured Group Program.
Information about Scam Risks to Medi-Cal Members
April 28, 2023
DHCS is aware of scammers and bad actors nationwide contacting Medicaid members requesting a fee to help them apply for or renew their Medicaid coverage. Medi-Cal members in California are also being targeted.
Medi-Cal members should know that Medi-Cal never requires payment during the application or renewal process.
DHCS urges stakeholders to use our toolkits in all outreach efforts. Additionally, it is important to educate Medi-Cal members about how they can expect to be contacted through official legitimate sources. If there are questions, Medi-Cal members can work with their local community partners or contact their county Medi-Cal office.
DHCS Telehealth Policy Updates
January 6, 2023
DHCS is making permanent many telehealth flexibilities from the COVID-19 public health emergency (PHE), including payment parity and broad coverage for clinically appropriate telehealth services. The updated policy will be published on January 16 in the Medi-Cal Provider Manual for telehealth, which will contain guidance on consent, establishing new patients via telehealth, billing guidance for services provided via audio-only, and brief virtual communications and check-ins. Medi-Cal Telehealth webpage.
Changes in Public Charge Rule Implementation
December 23, 2022
On December 22, DHCS released All County Welfare Directors Letter (ACWDL) 22-34 to inform counties of the final rule, entitled “Public Charge Ground of Inadmissibility” (2022 Final Rule), published by the U.S. Department of Homeland Security on September 9, 2022. Effective December 23, the 2022 Final Rule restores previous policies, including the exclusion of Medicaid when determining the use of public benefits, with the exception of long-term institutionalized care, and will apply to applications for visas, admission, and adjustment of status postmarked on or after the effective date. The ACWDL reminds counties that the 2022 Final Rule does not change whether individuals can apply for and receive public benefits. The public charge status of a Medi-Cal applicant or member has no impact on their eligibility for Medi-Cal benefits. In September, an updated Public Charge Guide was posted (in 21 languages) on the California Health & Human Services Agency website to serve as a resource for individuals and families with questions about the current federal public charge policy.
Four New Documents from MASAC
May 19, 2023
NHF’s Medical and Scientific Advisory Council (MASAC) recently issued four new documents, which are now available for easy access. These documents include:
• MASAC Recommendations Regarding Physical Therapy Management for the Care of Persons with Bleeding Disorders
• MASAC Recommendations Concerning Products Licensed for the Treatment of Hemophilia and Selected Disorders of the Coagulation System
• MASAC Recommendations on Hemophilia Treatment Center Preparedness for Delivering Gene Therapy for Hemophilia
• MASAC Recommendations on Administration of Vaccines to Individuals with Bleeding Disorders
For more information please visit the National Hemophilia Foundation website.
HCS Director Baass’ Message about the end of the COVID-19 Public Health Emergency
May 12, 2023
As a reminder, the end of the federal COVID-19 PHE has implications for Medicaid and the Children’s Health Insurance Program (CHIP). DHCS acted to make permanent several flexibilities implemented over the course of the PHE. Below is a summary of end dates for key federal Medicaid provisions, with additional details on how DHCS unwound the PHE in the Medi-Cal program.
Medicaid and CHIP COVID-19 provisions under the American Rescue Plan Act (ARPA):
- No-Cost Coverage for COVID-19 Vaccines, Testing, and Treatment for Medi-Cal Members: Medicaid is required to cover COVID-19 vaccines, testing, and treatment with no cost-sharing for members through the end of the ARPA coverage period on September 30, 2024. DHCS is electing to permanently extend coverage for COVID-19 vaccines, testing, and treatment beyond the ARPA coverage period.
- Optional COVID-19 Group for Uninsured Individuals: California has taken advantage of the “optional COVID-19 group,” also referred to as the COVID-19 Uninsured Group, that provided uninsured individuals with coverage for COVID-19 vaccines, testing, and treatment. This coverage expires on May 31 and DHCS began sending notices to individuals enrolled in the COVID-19 Uninsured Group about the program’s sunset along with a Single Streamlined Application to apply for Medi-Cal or Covered California coverage in late April 2023.
- Enhanced Federal Match for COVID-19 Vaccines and Vaccine Administration: States receive 100 percent federal matching funds for coverage of vaccines and vaccine administration, as enacted by ARPA. These matching funds also end on September 30, 2024. As described above, Medi-Cal will continue to cover COVID-19 vaccines.
Click here to read more about Statutory Flexibilities Status and Moving Forward.
Five Plans to Serve Medi-Cal Managed Care Members under Agreement
January 6, 2023
On December 30, DHCS and five commercial health plans – Blue Cross of California Partnership Plan (“Anthem”), Blue Shield of California Promise Health Plan, CHG Foundation d.b.a. Community Health Group Partnership Plan, Health Net Community Solutions, Inc. and Molina Healthcare of California – announced an agreement to deliver Medi-Cal services to Medi-Cal managed care members in 21 counties across the state starting in January 2024. RFP #20-10029 for the Medi-Cal MCPs was cancelled.
Public Health Emergency Decoupled from California Medi-Cal Redeterminations as of April 1
January 4, 2023
On December 29, President Biden signed into law the Consolidated Appropriations Act of 2023 (also referred to as the omnibus spending bill), which has broad implications for the Medi-Cal program and in particular the resumption of Medi-Cal redeterminations. Previously, the resumption of Medi-Cal redeterminations was tied to the termination of the COVID-19 public health emergency (PHE). With the passage of this bill, the continuous coverage requirements that paused all Medi-Cal redeterminations since March 2020 would be decoupled from the PHE termination date as of April 1, 2023, setting the stage for the resumption of Medi-Cal redeterminations.
Click here to read more about the upcoming end of the continuous coverage requirement.
About the Health Care Access Forums
HCC hosts quarterly Health Care Access Forums each year, connecting stakeholders to discuss and address solutions to potential threats and significant changes to public and private health insurance, state programs, therapies and services, and provider relationships that affect quality of care for people with bleeding disorders. HCC’s Health Care Access Forums help solve patient access issues and improve collaboration among healthcare providers, pharmacies, and state health care departments.
2023 Health Care Access Forum Dates
Thursday, February 2 (HYBRID)
Thursday, May 25 (online-only)
Thursday, September 21 (HYBRID)
Thursday, December 7 (online-only)
Don’t forget to get your 2023 Health Care Access Forum Membership! You can find the different options below-
To request an invoice, pay via check, or for any other questions regarding membership, please email apalladino@hemophiliaca.org.
For purchasing additional tickets, enter your information below. Extra tickets are only available to current forum members.