On September 3, the Department of Health Care Services (DHCS) published a memorandum that includes several policy changes for 2021. Effective January 1, 2021, DHCS will be carving in coverage of transplants and Long Term Care (LTC) into all Medi-Cal managed care health plan (MCP) model types. The LTC carve-in includes but is not limited to:
- Skilled nursing facilities
- Subacute facilities
- Pediatric subacute facilities
- Intermediate care facilities
- ICF/DD (Developmentally Disabled)
- ICF/DDH (Habilitative)
- ICF/DDN (Nursing)
Additionally, and also effective January 1, 2021, DHCS will be carving out the Multipurpose Senior Services Program (MSSP) benefit from the Coordinated Care Initiative (including Medi-Cal MLTSS MCPs and Cal MediConnect plans) in all seven counties of operation including Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Mateo, and Santa Clara. In these counties, beginning in 2021, MSSP will operate as a waiver benefit, as it did prior to the implementation of the Coordinated Care Initiative in 2014.
DHCS will provide additional details pertaining to this announcement in the near future. Send any questions to CalAIM@dhcs.ca.gov.