DHCS Guidance for Application & Requirements – Acute Hospital Care at Home Program

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Date: January 5, 2021
To: HPSJ Providers (HPSJ) Hospitals
From: Health Plan of San Joaquin
Subject: DHCS Guidance for Application & Requirements – Acute Hospital Care at Home Program
Business: Medi-Cal

The California Department of Health Care Services (DHCS) has now issued guidance for hospitals under contract with Medi-Cal managed care plans, such as Health Plan of San Joaquin, and that wish to apply for and participate in the CMS (Centers for Medicare and Medicaid Services) Acute Hospital Care at Home program. The program aims to alleviate pressure on hospitals during the COVID-19 pandemic by increasing their capacity to provide quality patient care outside a traditional hospital setting.

For the duration of this program, hospitals can apply for and receive a CMS waiver that may provide approved acute care inpatient services to eligible members at home. The attached All Plan Letter outlines key points of the Acute Hospital Care at Home
program, including:

    1. Program background
    2. Health Plan of San Joaquin (HPSJ) responsibilities, including authorizing medically appropriate acute care inpatient services at home for members, as well as tracking requirements, monthly reports to DHCS, and compliance for subcontractors and network providers
      Any hospital applying to participate must notify the HPSJ Provider Services Department. HPSJ Provider Services Representatives are available to assist if hospital
      staff have questions.
    3. Overview – Hospital needs to meet all the requirements to provide the acute level of care at home; the health plan is required to monitor the hospital’s compliance with the regulatory requirements
    4. Links, including the CMS online waiver application portal

    The UM notification requirements for any patient being admitted for home acute care services is the same as an inpatient acute hospital admission. It is the HPSJ member’s choice to receive these services in the home or the traditional hospital setting, and members who do not wish to receive them at home will not be required to do so.

    ATTACHED: All Plan Letter (APL 20-021) – 4 pages

Posted on January 5th, 2021 and last modified on January 5th, 2021.