State Officials Express Confidence in Gold Coast Improving Operations
On Tuesday, a California Department of Health Care Services official said the state is confident that Gold Coast Health Plan can make changes to improve its operations, the Ventura County Star reports (Kisken, Ventura County Star, 10/23).
Background
Gold Coast Health Plan launched in 2011 as an HMO-style alternative for certain beneficiaries of Medi-Cal, California's Medicaid program. The plan administers Medi-Cal to more than 100,000 Ventura County residents who are low-income or who have disabilities.
In the spring, the California Department of Health Care Services requested an audit of the managed-care plan after receiving complaints about late payments and poor management.
The audit raised concerns about how Gold Coast beneficiaries have been assigned to clinics and physicians.
In addition, a report from the Berkeley Research Group found that actual costs for Gold Coast Health Plan at times have been higher than reported expenses.
The findings raised concern among state officials about the plan's solvency (California Healthline, 6/20).
Details of Corrective Action Plan
Earlier this month, state officials imposed a corrective action plan that Gold Coast must complete by the end of the year.
The plan requires that Gold Coast:
- Fill several vacant leadership positions, such as chief financial officer and chief operating officer;
- Improve its equity; and
- Reduce its payment backlog.
If Gold Coast does not successfully execute the plan, it can be subject to penalties ranging from sanctions to the termination of its $300 million annual Medi-Cal contract.
Progress in Executing Plan
Margaret Tatar -- chief of the DHCS' Medi-Cal Managed Care division -- said that state officials are confident that Gold Coast leaders will implement changes using the state's "road map." She added, "We're confident the plan will succeed."
Gold Coast officials said they already have made significant progress in implementing the plan.
Robert Gonzalez -- chair of the Gold Coast governing commission -- said, "We intend to meet every one of the state requirements" (Ventura County Star, 10/23). 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.