DHCS delays dual-eligible pilot project until next year

May 07, 2013

The California Department of Health Care Services (DHCS) announced this week that it would delay the implementation of the state's "pilot project" to redesign care for Medicare/Medi-Cal dual eligibles. The program, called CalMediConnect, is now expected to begin no earlier than January 2014. Previously, implementation was scheduled for October 2013.

The project was authorized by the Assembly in July 2012 in an effort to save money and better coordinate care for the state’s low-income seniors and persons with disabilities. The program begins with a three-year demonstration project that would see a large portion of the state's dual eligible beneficiaries transition to managed care plans. 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 Medical Association (CMA) had urged DHCS to withdraw the overly-ambitious project proposal and to take more time to develop a scaled-down project that gives seniors and the professionals that take care of them information and feedback mechanisms to assure continuity of care and improved care coordination. Unfortunately, the Centers for Medicare and Medicaid Services approved the project last month, clearing the state to begin implementation.

CMA will work with DHCS and other stakeholders to minimize the impact of the transition on physicians and their patients.


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