March 04, 2013
Area(s) of Interest: Access to Care
The Department of Health Care Services (DHCS) announced last week that it has selected four health plans to provide managed care services to approximately 410,000 Medi-Cal beneficiaries in 28 rural counties. The selections are contingent upon each plan meeting stringent readiness criteria.
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 Medi-Cal managed care program into all of California’s 58 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, effective June 1, 2013.
The plans selected by DHCS include Anthem Blue Cross and California Health and Wellness Plan, which received Notices of Intent to Award for the expansion of Medi-Cal managed care to the counties of Alpine, Amador, Butte, Calaveras, Colusa, El Dorado, Glenn, Inyo, Mariposa, Mono, Nevada, Placer, Plumas, Sierra, Sutter, Tehama, Tuolumne and Yuba.
The state is also planning an exclusive Medi-Cal managed care contract with Partnership HealthPlan of California for expansion in Del Norte, Humboldt, Lassen, Modoc, Shasta, Siskiyou and Trinity counties. In addition, Lake and San Benito counties would become County Organized Health System managed care counties served by Partnership HealthPlan of California and Central California Alliance for Health, respectively. DHCS is currently working with Imperial County on its managed care plan selection process.
Click here for more information on Medi-Cal Managed Care Rural Expansion.
The California Medical Association will provide members with additional details as they become available.