Coordinated Care Initiative Update – February 4, 2014

The Coordinated Care Initiative represents a historic effort to integrate the medical, social, and mental health services provided to some of the most vulnerable Californians. DHCS is grateful for all of the stakeholder participation to move this effort forward. The state has come a long way and is excited to start this new program.

DHCS places a high premium on beneficiary protections and is working deliberately to ensure a successful implementation. The CCI will launch in April 2014 and phase-in over time, reflecting readiness of each individual county.  To ensure program readiness and to support beneficiary choice, today the state has two announcements:

  • CCI Enrollment Update: To ensure beneficiaries in the inaugural month of CCI have sufficient time to understand and review their options, beneficiaries in Riverside, San Bernardino and San Diego counties will have a 30 day voluntary period during April.  Those counties will begin passive enrollment in May.  Passive enrollment in San Mateo County still will begin in April, as will enrollment in Medi-Cal managed care for long-term services and supports in several counties.  An updated enrollment chart will made be available prior to tomorrow’s stakeholder call (see below for more details).
  • LA Enrollment Strategy: In designing Cal MediConnect, DHCS relied on the existing Medi-Cal model of managed care, with LA Care and Health Net serving the Cal MediConnect population as they serve Medi-Cal today in Los Angeles County. While LA Care received 3.5 Medicare stars for Part C, other Medicare quality measures resulted in LA Care being unable to accept passive enrollment for Cal MediConnect as planned. Under today’s announcement, DHCS will offer beneficiaries a greater choice of Cal MediConnect plans in Los Angeles County.  In addition to Health Net and LA Care, three other plans will be offered.  To preserve the Two Plan Model while moving forward with Cal MediConnect, DHCS has developed a solution specific to Cal MediConnect.  For Cal MediConnect beneficiaries, California will passively enroll beneficiaries directly into Cal MediConnect eligible plans-CareMore, Care 1st, Molina, and Health Net-no sooner than July 2014. To be eligible, a plan must be a Medi-Cal participating plan, a Medicare participating plan, and have undergone Cal MediConnect plan readiness review.  Once LA Care improves its Medicare quality rating, LA Care would be eligible to begin receiving passive enrollment.

Stakeholder Event – February 5, 2014: 

In an effort to keep interested parties informed and apprised of the latest developments of the Coordinated Care Initiative, the Department of Health Care Services will have a stakeholder call to discuss these updates and answer questions. This call will be Wednesday, February 5th from 3 to 4pm.

Click here to register for the stakeholder call on February 5th.

Meeting Materials:

 

DHCS thanks all stakeholder for their ongoing interest in the CCI.  Please submit questions to info@calduals.org.

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