CMS has posted the California specific tool that will guide the readiness review process for health plans participating in the Cal MediConnect program – the duals demonstration.
As part of the demonstration, CMS and DHCS want to ensure that every selected Cal MediConnect plan is ready to accept enrollment, protect and provide the necessary continuity of care, ensure access to the spectrum of Medicare, Medicaid, and pharmacy providers, and fully meet the diverse needs of the Medicare-Medicaid population. As such, every selected plan must pass a comprehensive joint CMS/State readiness review.
CMS and California worked collaboratively to develop the state-specific readiness review tools. The tools are based on stakeholder feedback received through letters and public meetings, the content of the Memorandum of Understandings, state-specific procurement documents, applicable Medicare and Medicaid regulations, and input received on previous tools.