Bill Could Pave Way for Expanded Medi-Cal Managed Care Plans
Pending legislation (SB 1332) would create a pilot project that would require seniors and people with disabilities in Riverside and San Bernardino counties who are eligible for Medi-Cal to enroll in managed care plans, the Sacramento Business Journal reports. The proposal would save about $21.7 million annually.
The bill, by Assembly member Gloria McLeod (D-Montclair), could help pave the way for mandatory managed care for seniors and Medi-Cal beneficiaries with disabilities statewide, a move that Gov. Arnold Schwarzenegger (R) included in his 2005 Medi-Cal redesign proposal. The Legislature has not approved other bills that would have mandated Medi-Cal managed care enrollment for seniors and people with disabilities.
Other states -- such as Ohio, Texas, and Washington state -- have had success with the requirement, according to Stephen O'Dell, president and CEO of Long Beach-based Molina Healthcare, which supports SB 1332. Molina specializes in managed care plans for Medicaid.
In addition, a recent study by Health Management Associates projects that making enrollment in Medi-Cal managed care mandatory for senior beneficiaries and those with disabilities could save the state as much as $192 million annually. Molina funded the study.
In addition to Molina, health plans, health maintenance organizations and their trade associations back the legislation. Other supporters of expanding Medi-Cal managed care are:
- Anthem Blue Cross, formerly Blue Cross of California;
- California Association of Physician Groups; and
- Health Net.
Stan Rosenstein, the head of Medi-Cal, said the administration supports expanding Medi-Cal managed care for seniors and people with disabilities.
However, the governor has not stated a position on SB 1332.
Deborah Doctor -- a legislative advocate for Protection & Advocacy, a disability advocacy organization -- said the organization's board "does not support Medi-Cal managed care for people with disabilities" or mandatory enrollment policies.
The California Medical Association has not taken a position on the bill but opposed the mandatory managed care provision in Schwarzenegger's Medi-Cal redesign plan (Robertson, Sacramento Business Journal, 4/14).