August 16, 2023
In late 2022, the California Department of Health Care Services (DHCS) reached an agreement with five commercial managed care plans to deliver Medi-Cal services in 21 counties across the state starting in January 2024. As a result, approximately 1.2 million Medi-Cal patients will be required to transition to a new a new health plan, and in some counties Medi-Cal patients will have the ability to select from more than one plan.
Recently, the California Medical Association and DHCS held a webinar to help physicians understand and prepare for the transition. This webinar, Medi-Cal Managed Care Plan Transition in January 2024 - What Physicians Should Know, is now available free for on-demand viewing at cmadocs.org/webinars. The webinar provides an overview of the transition, including health plan changes by county, work underway to ensure a smooth transition, the enrollee continuity of care policy, and physician and patient resources available.
DHCS has also published a Medi-Cal Managed Care Plan Transition Policy Guide, which includes a table that lists Medi-Cal managed care plan changes slated to take effect January 1, 2024, and relevant transition-related policies by county. Physicians are encouraged to review the table to see what changes are coming to their counties.
The policy guide also contains DHCS policy and plan requirements, including:
- Member enrollment and noticing requirements
- Continuity of care requirements
- Enhanced Care Management and Community Supports transition policies