Provider Digest | Issue 23

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New CEO, rate adjustments + dementia care

Introducing Michael Schrader, our new CEO

After an extensive nationwide search, we are pleased to announce Michael Schrader as the Alliance’s next Chief Executive Officer (CEO), succeeding Stephanie Sonnenshine, who announced her resignation last year.

“I am most pleased to join the Alliance because of its people, culture and mission,” said Schrader. “My desire is to foster an uplifting culture that affords caring and compassionate service for members, in partnership with local partners and community-based organizations. I look forward to the rewarding opportunities as the Alliance continually evolves to meet the needs of members and to further its vision of healthy people, healthy communities.”

Read the full press release on our website.

Medi-Cal reimbursement rate adjustments

The Department of Health Care Services (DHCS) has adjusted certain Medi-Cal reimbursement rates for clinical laboratory services.

Assembly Bill 133 (Chapter 143, Statutes 2021) as codified at Welfare and Institutions Code (W&I Code), Section 14105.222, requires DHCS to update reimbursement rates for clinical laboratory or laboratory services effective July 1, 2022, to not exceed 100 percent of the lowest maximum allowance established by the federal Medicare Clinical Laboratory fee schedule and Medicare Physician Fee Schedule for the same or similar service, effective Jan. 1 of the previous state fiscal year.

In addition, DHCS has adjusted reimbursement for clinical laboratory services previously priced as $0.00 to 100 percent of the corresponding 2022 Medicare Rate, where available, effective July 1, 2022.

DHCS has posted the impacted rates and effective dates on their Medi-Cal Rates webpage. For more information, please review Article 4 of the March 2023 Medi-Cal Update (Bulletin 585).

The Alliance will be implementing the rates effective May 1, 2023, in accordance with Alliance Policy 600-1050 – Implementation of Medi-Cal Rates. No action is required on your part.

Thank you for your partnership!

Dementia screening and warmline

New tools are available to Medi-Cal providers to help improve quality of life for patients living with dementia. These include a cognitive health assessment and warmline.

Primary care providers can now use the Dementia Care Aware cognitive health assessment to assess cognitive decline in patients 65 and older, and to determine next steps. Please note that this assessment is for patients who have Medi-Cal insurance only. Patients who have both Medi-Cal and Medicare are not eligible.

The Dementia Care Aware Warmline is available to support providers with dementia-related questions. The warmline offers education and decision-making consultation for clinicians and primary care teams in California.

You can call about:

  • Dementia screening.
  • Assessment.
  • Diagnosis.
  • Management.
  • Care planning.

Call 800-933-1789 from Monday to Friday between 9 a.m. and 5 p.m. If you leave a voicemail message after these hours, it will be returned on the next business day. You may also submit an online request on the Dementia Care Aware website.

Note: Consultations are not intended as a substitute for professional medical care or advice, nor to replace a health care professional’s clinical judgment regarding their individual patient care.

For more details, including training and billing for the cognitive health assessment, please review the DHCS news release.