House Members Ask CMS To Postpone Managed Care Shift
On Tuesday, 14 House members from CaliforniaÂ sent a letter to CMS requesting that the federal government further delay moving hundreds of thousands of patients with disabilitiesÂ and seniors with chronic illnesses into Medi-Cal managed care plans, the Los Angeles Times' "L.A. Now" reports.
Medi-Cal is California's Medicaid program (Gorman, "L.A. Now," Los Angeles Times, 6/4).
The Cal MediConnect duals demonstration program will cover about 456,000 Californians who are eligible for both Medicare and Medi-Cal in eight counties, including:
- Los Angeles;
- San Bernardino;
- San Diego;
- San Mateo; and
- Santa Clara (Gorn, "Capitol Desk," California Healthline, 3/28).
The program aims to combine services and funding from Medicare and Medi-Cal to improve and better coordinate care and reduce health care costs.
Last month, the state Department of Health Care Services announced that it was delaying the start of the program from October until at least January 2014 (Gorn, "Capitol Desk," California Healthline, 5/10).
Details of Letter
In the letter, the House members said that they have heard concerns from health care providers and patient advocates that the program's savings targets are overly ambitious and arbitrary. They said the savings targets could result in paired down services ("L.A. Now," Los Angeles Times, 6/4).
They wrote, "While we appreciate" the delay in the launch of the program, "we remain concerned that the timeframe and scope are not conducive to a seamless transition for beneficiaries."
According to the letter, the House members "are very concerned that, in the effort to create savings, patients could be denied access to quality care."
The House members added, "We do not believe enough information has been made available about how the savings rates were calculated and whether patients and providers in L.A. County can reasonably be expected to improve the quality of care for dual eligible beneficiaries under those rates."
According to the letter, CMS should make sure that the network of providers participating in the program is strong enough to provide adequate care for dual eligibles (House letter, 6/4).
In a statement released Tuesday, DHCS said that health officials in California are trying not to disrupt care for individuals while launching a "historic effort" to provide dual eligibles with more coordinated care.The agency said that it will conduct a review to ensure that health plans are prepared for the program and that networks of health care providers can meet the needs of dual eligibles ("L.A. Now," Los Angeles Times, 6/4). This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.