Federal health officials approve changes to speed California’s efforts against COVID-19

The Centers for Medicare & Medicaid Services (CMS) on Monday approved rule changes sought under an 1135 waiver request that will enable the California Department of Health Care Services (DHCS) to more effectively and efficiently deliver care to Californians covered by Medi-Cal during the COVID-19 emergency.

 

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The changes approved included significant items requested by DHCS that will speed care to those who need it:

  • More flexibility in allowing out-of-state doctors and other medical providers to treat California patients, both in person and through telehealth.
  • Changes to allow for efficient use of hospital capacity and shift patients to appropriate care settings, maximizing the state’s ability to treat those in need.
  • Modifications to prior authorization rules on treatment and the establishment of medical necessity, enabling the health care system to more quickly respond to the rapidly evolving situation.

“We are tremendously pleased that CMS responded so quickly to our request,” said Jacey Cooper, California’s State Medicaid Director. “CMS is still reviewing California’s remaining 1135 requests and we look forward to working closely with them to receive approval of the pending items that will help our state meet the challenge posed by COVID-19.”

DHCS will provide information to stakeholders as soon as possible about the pending 1135 waiver requests once CMS decides whether to approve them.

DHCS requested a series of rule waivers on March 16 and March 19 under Section 1135 of the Social Security Act, used to provide flexibility during national health emergencies. Portions of California’s requests were granted by CMS in a March 23, 2020, letter.

“We will be rolling out guidance to our provider partners by March 26 so they can quickly take advantage of this new flexibility to provide high-quality health care to the Californians we serve through the Medi-Cal system,” said Cooper.

DHCS administers Medi-Cal, California’s version of Medicaid, providing health coverage to about 13 million people.

This press release was provided by the California Department of Health Care Services.