April 19, 2013
Area(s) of Interest: Payor Contracting Payor Issues and Reimbursement
The Department of Health Care Services (DHCS) announced last week that the transition of rural Medi-Cal fee-for-service to managed care will be delayed from June 1 to September 1. The department said the delay is necessary in order to ensure a smooth transition process for enrollees.
The California Legislature authorized, as part of last year's budget, the expansion of Medi-Cal managed care into rural fee-for-service counties, expanding the Medi-Cal managed care program into 28 California counties. This expansion is part of the governor's plan to reduce costs in the Medi-Cal program. Under the expansion program, eligible Medi-Cal enrollees will be required to enroll in a Medi-Cal managed care program in order to receive services.
The expansion of managed care includes the following rural fee-for-services counties: Alpine, Amador, Butte, Calaveras, Colusa, Del Norte, El Dorado, Glenn, Humboldt, Imperial, Inyo, Lake, Lassen, Mariposa, Modoc, Mono, Nevada, Placer, Plumas, San Benito, Shasta, Sierra, Siskiyou, Sutter, Tehama, Trinity, Tuolumne and Yuba.
Click here for more information on Medi-Cal Managed Care Rural Expansion.