Mandatory Enrollment Draws Attention From Legislators

The state wants to move fee-for-service Medi-Cal beneficiaries who are seniors and persons with disabilities into managed care plans. At the same time, the state is in the initial stages of launching a demonstration project to eventually move up to 1.1 million dual eligibles — those eligible for both Medicare and Medi-Cal benefits — into managed care.

Today in Sacramento, those two significant efforts get some legislative oversight. The Senate and Assembly health committees are holding a joint hearing on how those two efforts will be conducted.

“We want the health care system to be more efficient, but without sacrificing patient care,” Assembly member Bill Monning (D-Carmel) said. “The objective [of both efforts] is to improve patient care. So this is an opportunity to have some transparency for the public and some oversight.”

It has been about six months since the state started its conversion for SPDs (seniors and persons with disabilities), “so this is our six-month check-in on the SPD program,” Monning said, “and we’d like to be updated on the duals program, as well.”

There may be lessons learned in the first half-year of SPD program operation that may pertain to the upcoming implementation of the duals plan, Monning said. “The purpose and goal is to help shape implementation of the transitions of SPDs and duals,” he said. “It gives the department (state Department of Health Care Services) an opportunity to present what they’re doing and gives advocacy groups a chance to offer opinions about how it’s going.”

Monning also said he is concerned about the transition of Medi-Cal services from the Department of Mental Health to the Department of Health Care Services. He said that issue might be the focus of a future hearing.

“Of course, that’s not the primary focus of this hearing, but I am particularly concerned about the transition of mental health services,” Monning said. “At the time of the budget negotiations, I was concerned about it. I know it’s delicate. But I think you have to have a clear commitment to the resources and monitoring for mental health care.”

Today’s hearing will be co-chaired by Monning and Senate member Ed Hernandez (D-West Covina). Jane Ogle, deputy director for Health Care Delivery Systems, will represent DHCS.

Related Topics

Capitol Desk Medi-Cal Medicare