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.