Health Care Access Forum – Thursday, February 2nd
9:00 AM – 10 AM Registration and Networking
9:15 AM – 10 AM Virtual Networking Breakout Rooms
10 AM – Noon Forum
Location: California Endowment Center for Healthy Communities
(1414 K Street, Sacramento in the 1st Floor Adelante Room)
Virtual via Zoom
This is a members-only event. Deadline to Register is Friday, February 27th!
Need help registering? Please email Andrea at firstname.lastname@example.org
FORUM TRAVEL AND LODGING INFORMATION
FROM THE EAST:
(NORTH LAKE TAHOE / NEVADA CITY / GRASS VALLEY AREA):
Take I-80 West to I-5 South Take the J Street exit toward Downtown Stay on J Street and turn right on 15th Street Turn right on L Street Turn right on 14th Street
(SOUTH LAKE TAHOE / PLACERVILLE AREA):
Take Highway 50 West Take the 16th Street exit Turn right at 16th Street Turn left at L Street Turn right on 14th Street
FROM THE NORTH (REDDING AREA):
Take I-5 South Take the J Street exit toward Downtown Stay on J Street and turn right on 15th Street Turn right on L Street Turn right on 14th Street
FROM THE SOUTH (STOCKTON AREA):
Take I-5 North Take the J Street exit toward Downtown Stay on J Street and turn right on 15th Street Turn right on L Street Turn right on 14th Street
FROM THE WEST (SAN FRANCISCO AREA):
Take I-80 East to I-5 North Take the J Street exit toward Downtown Stay on J Street and turn right on 15th Street Turn right on L Street Turn right on 14th Street
FROM SACRAMENTO INTERNATIONAL AIRPORT:
Take I-5 South Take J street exit Turn right onto 15th Street Turn right onto L Street Turn right on 14th Street
Parking is available on a first-come, first-served basis across the street at Capitol Centre parking garage or the Capitol Garage for an hourly fee. Additional parking may also be found in surrounding buildings or on the street for an hourly fee.
- Capitol Garage (Next to Capitol Centre)
1500 K Street
Rates: each 20 minutes = $2.00 Hourly: $6.00 Daily max of $24.00
Exact change and all major credit cards
Across the street from the venue
- Priority Parking Lot at J and 16th Street
1600 J Street
Rate: $10 per day
Accepts exact change and all major credit cards
4 min walk to venue
- Priority Parking Lot off Jazz Alley
1621 K Street
Rate $10 per day
Accepts all major credit cards, no cash
5 min walk to venue
These hotels are for your reference if you will be staying overnight in Sacramento. Please call hotels individually for rates. The California Endowment has some discounts on their webpage under “Lodging and Directions”.
- Residence Inn Marriott Downtown Capitol Park
Across the street
1121 15th St.
- Sheraton Grand
.3 Miles away
1230 “J” St.
*Corporate SET ID: CQ2.
Go to marriott.com/SACSI
• Enter your reservation dates
• Under Special Rates click Corporate/Promo/Set ID and enter your ID
• Click “Continue”
- Citizen Hotel
Rate: 12% off BAR
926 J St.
Lisa Ghotbi Appointed Chief, Pharmacy Benefits Division (PBD) at DHCS
January 17, 2023
The Department of Health Care Services (DHCS) is pleased to announce the appointment of Lisa Ghotbi, Chief, Pharmacy Benefits Division (PBD), effective January 17, 2023.
Dr. Ghotbi has over 30 years of experience in the field of Pharmacy Benefit Management. Most recently, she served as the Director of Pharmacy Services with the San Francisco Health Plan. In this role, Dr. Ghotbi had oversight and participated in cross-functional efforts of data management, fraud/waste/abuse, compliance, financial projections, and care management. Additionally, she managed the multi-million dollar pharmacy budget, oversaw pharmacy benefit management, and ensured compliance with State regulations. Prior to this role, Dr. Ghotbi served as Deputy Director and Chief Operating Officer (COO) of the City and County of San Francisco, Health Service System. In this role as COO, Dr. Ghotbi was responsible for overseeing a board-governed multiemployer system responsible for benefit administration for employee and retiree families.
Dr. Ghotbi earned a Doctorate in Pharmacy from the University of California, San Francisco and is a registered Pharmacist. She is a board member of the UCSF Pharmacy Alumni Association. Dr. Ghotbi is honored to join DHCS and is looking forward to leading the work ahead.
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.
30-Day Countdown – Reinstatement of Prior Authorization Requirements for 47 Drug Classes Including Medical Supplies
January 24, 2023
On February 24, 2023, prior authorization (PA) requirements will be reinstated for 47 additional Standard Therapeutic Classes (STCs), including medical supplies, for new start prescriptions for beneficiaries 22 years of age and older.
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.
Now Active – Physician Administered
Drug Policy Updates
September 16, 2022
What is Happening?
The Physician Administered Drug (PAD) policy is updated as follows:
Pharmacy claims for PADs not typically approved for and dispensed by pharmacy providers will deny with Reject Code 816 – Pharmacy Drug Benefit Exclusion. An exception for pharmacy benefit approval may be considered via prior authorization request and may be covered as a pharmacy benefit.
- Pharmacy providers and prescribers are encouraged to assess their business processes and workflows to account for the PAD policy update.
- Refer to the Medi-Cal Rx Bulletins & News and Medi-Cal Rx Forms & Information pages of the Medi-Cal Rx Web Portal to stay up to date.
- Providers can learn more by consulting the Medi-Cal Rx Pharmacy Reimbursable Physician Administered Drugs list.
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 14 (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-
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