The Department of Health Care Services (DHCS) is providing this update of significant developments this week related to DHCS programs, including guidance related to the COVID-19 emergency.
On April 3, 2020, DHCS submitted to the Centers for Medicare & Medicaid Services (CMS) a request for a waiver under Section 1115 of the Social Security Act and a Disaster State Plan Amendment seeking additional flexibilities to address the health care needs of California during the emergency.
In addition, on April 3, 2020, CMS notified DHCS that it has approved California’s request for a waiver of the broad-based and uniformity requirements related to the State’s managed care organization (MCO) tax, effective January 1, 2020. DHCS is currently evaluating the approval and what, if any, changes will be necessary.
CMS also recently approved the DHCS’ requests for five 1915(c) Home and Community-Based Services (HCBS) Waiver Appendix K amendments, which allow flexibilities during emergency situations that may impact the provision of health care services and California’s ability to meet certain HCBS Waiver requirements. The stand-alone Appendix K amendments are used to advise CMS of expected changes to HCBS Waiver operations or to request temporary amendments to approved Waivers. California received these Appendix K approvals for the period of February 4, 2020, to June 30, 2020, in response to challenges the State faces as a result of the ongoing COVID-19 emergency.
The individual waiver requests and approval letter are linked below:
- Appendix K Approval Letter
- Appendix K for 1915c Waivers: DDS
- Appendix K for 1915c Waivers: HCBA
- Appendix K for 1915c Waivers: ALW
- Appendix K for 1915c Waivers: HIV/AIDS
- Appendix K for 1915c Waivers: MSSP
DHCS also published additional and/or updated guidance for providers, beneficiaries and the public related to the COVID-19 emergency:
- Joint Guidance on Non-Discrimination in Medical Treatment for COVID-19
- Every Woman Counts Primary Care Provider Information Notice and Telephonic Enrollment Process
- Updated Medi-Cal Fee-For-Service (FFS) Prior Authorization Flexibilities Relative to COVID-19
- Updated Fee-for-Service Pharmacy: Flexibilities for Off-Label/Investigational Drugs in COVID-19-Related Treatment
- Updated Narcotic Treatment Program FAQs
- Behavioral Health Integration Incentive Program Delay
- Presumptive Eligibility in Child Health and Disability Program: COVID-19 Flexibilities
- Hospital Presumptive Eligibility: COVID-19 Flexibilities
- Presumptive Eligibility for Pregnant Women: COVID-19 Flexibilities
- APL 20-007: Policy Guidance For Community-Based Adult Services In Response to Covid-19 Public Health Emergency
Additional updates will be posted to the DHCS COVID-19 resource page