Latest California Healthline Stories
CMS, State Officials Halt Participation of CalOptima in Dual-Eligible Plan
Federal officials found “widespread and systemic” violations in an audit of Southern California insurer CalOptima, causing state officials to exclude Orange County residents — at least temporarily — from the Cal MediConnect conversion of dual-eligibles to Medi-Cal managed care.
Study: Dual Eligibles Worried About April Transition to Managed Care
A new study from UCLA says seniors are worried about the state’s duals demonstration project. Beginning in April, the state will move about 450,000 Californians eligible for Medicare and Medi-Cal into Medi-Cal managed care plans.
Medicare Briefing Examines Hospital Trend To Observe Rather Than Admit
A concern that hospitals might be delaying admission of Medicare patients got national attention in a televised Washington, D.C., briefing last week.
How California’s Dual-Eligibles Project Compares With Five Other States’ Plans
A new analysis by a seniors’ advocacy group lays out the similarities and differences between the appeals process for dual-eligible projects in six states, including California.
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.