Latest California Healthline Stories
Stakeholders Assess Delayed Duals Project
California’s duals demonstration project to coordinate care for those eligible for Medicare and Medi-Cal has been delayed until April.
Floor Vote Coming for ‘De-linking’ Plan
A legislative committee yesterday questioned a proposal to “de-link” some provisions of the Coordinated Care Initiative and to expand the role of the Department of Finance in the state’s plans for covering Californians eligible for Medicare and Medi-Cal.
State ‘De-links’ Mandatory Enrollment from Duals Project
The Department of Health Care Services last week announced a new provision of Cal MediConnect that would establish a means of abandoning the state’s duals demonstration project if it doesn’t meet a financial benchmark.
The department also wants to “de-link” mandatory enrollment from the demonstration project, according to Jane Ogle, deputy director at DHCS.
“On the program side, we de-linked mandatory enrollment of duals. That way, we’ll have long-term services and supports as Medi-Cal benefits,” she said.
‘So Many Moving Parts’ To Fit Together
The Department of Health Care Services announced this week that the Cal MediConnect duals demonstration project will not start until at least January, 2014, a delay from its previous expected launch date in October, 2013.
Advocates for seniors’ health care yesterday praised the decision, saying the extra three months will go a long way toward pulling all of the disparate pieces of Cal MediConnect into place.
“I think [the delay] comes from the general recognition that so many things have to happen, for so many people, speaking so many languages,” said Jack Hailey, project manager for Government Action and Communication Institute, and a contributor to the California Collaborative for Long Term Services and Supports.
Duals Demonstration Gets Green Light
CMS and California health officials yesterday announced they agree on a framework for the launch of the duals demonstration project starting as soon as October.
About 456,000 Californians who are dually eligible for Medicare and Medi-Cal coverage in the eight demonstration counties will be qualified to participate in the duals project.
State officials announced yesterday the project will be launched under the name Cal MediConnect.
Douglas Updates Legislators on Health System Changes
California’s health care system is undergoing its biggest changes in almost 50 years. Toby Douglas, director of the agency at the eye of the health care storm, updated legislators on the progress of some of the changes in a hearing last week in Sacramento.
Federal Approval of Duals Plan May Come Soon
At a budget subcommittee hearing yesterday, Department of Health Care Services Director Toby Douglas said he hopes to get federal approval for the Coordinated Care Initiative within weeks.
The CCI, also known as the duals demonstration project, is a plan to move half a million Californians with dual eligibility in both Medicare and Medicaid into Medi-Cal managed care programs. The plan calls for consolidating disparate health care services and funding streams to improve and integrate care for seniors and persons with disabilities, while saving the state money as well.
“We hope it’s imminent,” Douglas said at yesterday’s Budget Subcommittee on Health and Human Services, when he was asked for an approval timeline by Assembly member Mariko Yamada (D-Davis).
Medicare Drug Savings in California Estimated at $454 Million Over Two Years
California seniors and the disabled saved about $454 million on prescription drug costs in the past two years, according to an annual report on Medicare released by CMS Thursday.
According to federal officials, almost 300,000 Californians qualified in 2012 for the Part D Medicare coverage gap known as the “donut hole.” Last year, those beneficiaries saved roughly $183 million, the report said.
Those 300,000 Californians last year could buy covered brand name drugs at half price, and received a 14% discount on generic drugs. Savings for both types of prescription drugs will increase over time, the report said, until the coverage gap is closed.
Duals Project Edges Closer to Completion
More than 300 people attended a Department of Health Care Services seminar yesterday offering details of the duals demonstration project, also known as the Coordinated Care Initiative.
The department recently released several reports, including a draft of the care coordination and long-term services and supports readiness standards. Those guidelines are a big step toward the state’s readiness plan it eventually will need to submit to CMS, said Jane Ogle, deputy director of DHCS, at yesterday’s seminar.
The state released a summary of some of the significant details in the reports:
Higher Primary Care Rate Welcome News for California
Earlier this month, CMS made it official: The federal government will pay Medi-Cal primary care physicians in California at the same rate as Medicare in 2013 and 2014.
The higher rate, confirmed by CMS officials on Nov. 2, means more than just paying more to family practice, pediatrics and internal medicine physicians, said Kevin Prindiville, deputy director of the National Senior Citizens Law Center, a national legal advocacy group with an office in Oakland.
“We hope this will improve access,” Prindiville said, “and there aren’t too many things in our market-driven system that can do that.”