Advocates for seniors and the disabled filed a motion on Saturday asking a U.S. District Court judge in San Francisco to intervene in some implementation details of the settlement agreement it signed eight months ago with the Department of Health Care Services.
State officials yesterday answered some of the questions about the Oct. 1 implementation of the Community Based Adult Services program.
Some advocates worried about confusion around the launch of the CBAS program since the state is holding training sessions for the CBAS changeover in October for both health plans and physicians.
“We have been training plans prior to the transition,” said Norman Williams, deputy director of public affairs for DHCS. “We conducted co-trainings on Sept. 5 and Sept. 14 for managed care plans and providers in order to review the managed care transition and to train health plan clinical staff on the CBAS eligibility assessment process and use of the eligibility tool.”
That included training from health plan and provider perspectives, Williams said.
“We have offered to provide this training ongoing as needed by the plans. We have also provided a total of 26 notices to ADHC/CBAS providers over the last several months to address overall provider transition issues, including the transition to managed care,” Williams said. “We are reaching out to physician groups, the California Medical Association and other stakeholders during September and October to ensure that beneficiaries who choose to remain in FFS (fee-for-service, as opposed to managed care) fully understand the impact of that choice on their CBAS services.”
Williams said the department has been engaged in mediation with Disability Rights California to resolve any outstanding concerns, and that DHCS officials are confident about the upcoming Oct. 1 CBAS launch.
“CBAS beneficiaries will transition to managed care on Oct. 1 and will continue to receive CBAS services through their managed care plans,” Williams said. “Participants in non-managed care counties, or those ineligible for managed care, will continue to receive CBAS through fee-for-service.”
DHCS sent a number of instructional notices to beneficiaries, he said, to make sure they know how to enroll in a Medi-Cal managed care plan by Oct. 1, to ensure they keep their CBAS benefit. But about 5,000 beneficiaries opted to remain in fee-for-service plans, which makes them ineligible for CBAS as a Medi-Cal managed care benefit, Williams said.
Williams said the advocate uproar over the CBAS assessment has been misplaced.
“DHCS, plaintiff counsel and ADHC providers jointly developed the CBAS assessment tool last December pursuant to the settlement agreement,” Williams said. “DHCS has explicitly stated to providers, plans, and class counsel in writing and during recent webinar trainings that we will continue to use [the current version of the assessment tool] until we are able to resolve pending issues. DHCS will not implement a new version of the [assessment] without adequate time to review it with managed care plans, providers, and plaintiff counsel, and until training is provided on use of the revised [assessment].”KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.
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