DHCS Delays Dual-Eligible Pilot Project Until 2014

 

The California Department of Health Care Services (DHCS) has announced that it will delay the implementation of the state's "pilot project" to redesign healthcare for Medicare/Medi-Cal dual eligibles. The program, called Cal MediConnect, is now expected to begin no earlier than January 2014. Most recently, implementation had been scheduled for October 2013.

The project will impact approximately 450,000 duals in eight counties - Alameda, Los Angeles, Orange, Riverside, San Diego, San Mateo, San Bernardino, and Santa Clara.

Patients will be enrolled in a managed care plan unless they actively opt out.

The California Podiatric Medical Association (CPMA) along with the California Medical Association (CMA) and other stakeholders has continuously urged DHCS to withdraw the overly-ambitious project proposal in order to take more time to develop a scaled-down project that gives seniors and the healthcare professionals that provide care for this fragile population, information and feedback mechanisms to assure continuity of care and improved care coordination.

CPMA will continue to work with DHCS and other stakeholders to minimize the impact of the transition on members and their patients

IN ADDITION

CA House Members Ask CMS to Postpone Managed Care Shift

On Tuesday, June 4, 14 members of the US House of Representatives from California sent a letter to CMS requesting that the federal government further delay moving hundreds of thousands of patients with disabilities and seniors with chronic illnesses into Medi-Cal managed care plans.

In the letter, the House members said that they have heard concerns from health care providers and patient advocates that the program's savings targets are overly ambitious and arbitrary. They said the savings targets could result in paired down services

They wrote, "While we appreciate" the delay in the launch of the program, "we remain concerned that the time frame and scope are not conducive to a seamless transition for beneficiaries."

According to the letter, the House members "are very concerned that, in the effort to create savings, patients could be denied access to quality care."

The House members added, "We do not believe enough information has been made available about how the savings rates were calculated and whether patients and providers in L.A. County can reasonably be expected to improve the quality of care for dual eligible beneficiaries under those rates."

According to the letter, CMS should make sure that the network of providers participating in the program is strong enough to provide adequate care for dual eligibles (House letter, 6/4)

(Source; California Healthline 6/5/2013)