DHCS implements period of "deemed eligibility" for Cal MediConnect plans Effective September 1, 2015, Cal MediConnect will have the option to offer a one- or two-month period of “deemed eligibility,” defined as a grace period, to beneficiaries that lose Medi-Cal eligibility due to a change in circumstance. Cal MediConnect plans have the option to, but are not required to, offer this “grace period." According to the 2013 Medicare-Medicaid Plan Enrollment and Disenrollment Guidance, a Cal MediConnect plan may choose to provide a one- or two-month period of deemed continued eligibility for individuals who lose Medicaid eligibility, if the individual ... September 8, 2015 Medi-Cal Cal MediConnect 0 0 Comment Read More »
CMA publishes duals project FAQ The 2012 California state budget authorized a three-year demonstration project that transitions dual eligibles into managed care and allows them to receive medical, behavioral, long-term supports and services and home-and-community-based services coordinated through a single health plan. The Cal MediConnect project was approved in 8 counties: Alameda, Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Mateo, and Santa Clara. No more than 456,000 individuals will be allowed to enroll into Cal MediConnect. Los Angeles’ enrollment will be capped at 200,000. To help physicians and their patients better understand the program, ... October 21, 2014 Medi-Cal, Medicare Dual Eligible, Medi-Cal, Medicare, Cal MediConnect 0 0 Comment Read More »
DHCS releases duals project toolkit The California Department of Health Care Services (DHCS) has published a physician toolkit to help providers and their patients understand the Cal MediConnect duals demonstration project. The toolkit has been developed in conjunction with Harbage Consulting and various stakeholder groups, including the California Medical Association. The toolkit contains several documents, including an overview and several fact sheets that include information on the following: How to submit crossover claims to Medi-Cal plans Contracting with Cal MediConnect plans How crossover claims ... October 6, 2014 Medi-Cal, Medicare Dual Eligible, Medi-Cal, Medicare, Cal MediConnect 0 0 Comment Read More »
DHCS revises Cal MediConnect 'Choice Forms' After advocacy from the California Medical Association (CMA) in conjunction with patient advocacy groups, the California Department of Health Care Services (DHCS) has revised its “Choice Forms” that allow dual eligibles to opt-out of the Cal MediConnect duals demonstration project and remain in traditional Medicare fee for service. The project was authorized by the state in July 2012 in an effort to save money and better coordinate care for the state’s low-income seniors and persons with disabilities. The program begins with a three-year demonstration project that transitions a large portion ... September 11, 2014 Medicare Department of Health Care Services, DHCS, Dual Eligible, Medicare, Cal MediConnect 0 0 Comment Read More »
Cal MediConnect lawsuit unsuccessful Last week, the Sacramento Superior Court denied a request to delay implementation of the Cal MediConnect project. In a last minute challenge to the program, the Los Angeles County Medical Association (LACMA) joined a coalition of plaintiffs, including three Los Angeles independent living centers, to file a lawsuit in Sacramento Superior Court to stop the implementation of the project. The Cal MediConnect project was authorized by the state in July 2012 in an effort to save money and better coordinate care for the state’s low-income seniors and persons with disabilities. ... August 8, 2014 Medi-Cal, Medicare Dual Eligible, Medi-Cal, Medicare, Cal MediConnect 0 0 Comment Read More »
