Author: wendyp

August 20, 2012  –  California’s Department of Health Care Services has scheduled two stakeholder meetings on the Draft Coordinated Care Transition Plan. The Plan describes how DHCS intends to implement several important elements of the Duals Demonstration: Maintaining access and quality; Implementing beneficiary protection provisions; Consumer complaints process; and Incorporating stakeholder feedback.

Seniors, people with disabilities, advocates and service providers in Alameda County are encouraged to participate in one of the two sessions. The meetings are planned for Wednesday August 29 from 11 am to 12:30 pm, and Tuesday September 4 from 1 to 2:30 pm. The Duals Demonstration will launch next year in Alameda and seven other counties.

 

Return to the Coordinated Care Initiative page here.

September 20, 2012  – California’s Department of Health Care Services has released more details about exactly who will be required to participate in the Coordinated Care Initiative (CCI), and has more clearly articulated the two major components of the CCI: 1) the Duals Demonstration, and 2) the Integration of Long Term Services and Supports into Mandatory Medi-Cal Managed Care. Both are coming to Alameda County no earlier than April 2014.

1) The Integration of LTSS into Mandatory Medi-Cal Managed Care: Starting some time in 2014, all seniors and people with disabilities who have Medi-Cal coverage will be required to enroll in a Medi-Cal Managed Care Plan, with only a few exceptions. Enrollment includes some who were left out of last year’s mandatory Medi-Cal Managed Care launch, most notably full Duals (with Medicare A, B and D), partial Duals (with A or B) and many with Medi-Cal Share-of-Cost (those who meet their share-of-cost every month).

Once the launch is complete, enrollment in a Plan (either Alameda Alliance for Health, Anthem Blue Cross) will be the only way to receive Medi-Cal’s long term care services such as IHSS, MSSP, ADHC, and skilled nursing facility care.

2) The Duals Demonstration: In addition to being required to enroll in Medi-Cal Managed Care, most dually eligible seniors and people with disabilities (age 21 or older) will also have a decision to make: whether or not to enter the Dual Demonstration. Read DHCS’s description of groups included and excluded from the Duals Demonstration and the Mandatory Medi-Cal Managed Care.

 

Return to the Coordinated Care Initiative page here.

October 19, 2012  –  The Center for Medicare & Medicaid Services recently released their 2013 quality star ratings for managed care plans. 2013 quality star ratings for Medicare health and drug plans. The rated plans selected to participate in California’s Coordinated Care Initiative (CCI) received an average rating of 3 out of 5 stars  Click here to link to the rating summary for California CCI plans.

The 5-star rating system is used by CMS to monitor plans to ensure that they meet Medicare’s quality standards. The ratings provide Medicare beneficiaries with a tool to compare the quality of care and customer service that Medicare health and drug plans offer. CMS’ star rating system considers 53 quality measures, such as success in providing preventive services, managing chronic illness, and keeping consumer complaints to a minimum.

 

Return to the Coordinated Care Initiative page here.

January 16, 2013 – **Update: The Launch Date has been pushed back to no earlier than July 2014** Both the Duals Demonstration and Medi-Cal Managed Care LTSS were set to launch in eight counties – including Alameda County – as early as June 1, 2013. The Governor’s proposed budget had moved the launch date to September 2013 July 2014 and specifies that in Alameda County enrollment will be phased in over 12 months. This means that the first notices that any beneficiaries would have received about the transition would arrive no earlier than June 2013 April 2014.

California’s Coordinated Care Initiative (CCI), included in last year’s FY 2012-13 Budget, is a multi-year plan to coordinate health care and long term services and supports for dual eligibles (Medicare/Medi-Cal beneficiaries) and Medi-Cal Only seniors and people with disabilities. The CCI has two major components. The first incorporates Medi-Cal-covered Long Term Services and Supports (IHSS, ADHC, MSSP and skilled nursing facility) into Managed Care. The second component, the Duals Demonstration, integrates Medicare and Medi-Cal coverage into Managed Care Plans that coordinate both medical and long term services and supports.

Return to the Coordinated Care Initiative page here.