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Preparing for Medi-Cal Transition

State and federal officials are busy finalizing the Medicaid waiver — the agreement on how California should spend $10 billion in federal money on its state Medi-Cal program.

The new way Medi-Cal will run represents a bridge to the full implementation of federal health care reform policies that have to be in place by 2014.

The current negotiation is set to finish at the end of this month.

Meanwhile, many of the broader aspects of that historic change in Medi-Cal structure and programs have had some kind of agreement. It is expected, for example, that seniors and patients with disabilities will need to sign up for a managed care plan.

The often-contentious issue hasn’t yet been finalized, but in the event that it does become California policy, the state needs to be ready for it.

“The informing notice is done,” Elizabeth Landsberg, legislative advocate for the Western Center on Law and Poverty, said. “It will go out March 1.”

The law requires notice 90 days before enrollment, so everyone will get the one-page notice of the change at the start of March, Landsberg said.

“If you are disabled or a senior and you have Medi-Cal, then you will have to have an insurance plan,” she said. “So it’s important to have everyone get the informing notice first.”

The state plans a rolling enrollment based on people’s birthdays, she said. So about 380,000 seniors and the disabled who have Medi-Cal will get an enrollment packet 60 days before their birthday. “You’ll need to pick a plan, fill out the forms,” Landsberg said. “If you don’t, the department will choose a plan for you.”

A number of consumer advocacy groups have opposed the switch. But, Landsberg said, “Mandatory enrollment is happening, even though terms with the feds have not been finalized.”

Landsberg added that she hopes federal officials will put additional consumer protection requirements into the waiver agreement, but that’s something we won’t know for certain until Oct. 31.

However the details end up, it’s prudent of state officials to prepare for whatever the waiver agreement might say.

“We have to get everyone in the community aware of what’s going to happen,” Landsberg said. “Otherwise, people might panic. And you have to write that notice now,” she said. “March 1 is soon.”


Related Topics

Capitol Desk Medi-Cal