On March 27th, the Centers for Medicare and Medicaid Services (CMS) entered into a Memorandum of Understanding (MOU) with the California Department of Health Care Services (DHCS) to implement a dual eligible demonstration that will transform the way Medicare and Medi-Cal services are delivered to Californians that qualify for both programs.   The demonstration, now known as Cal MediConnect, is scheduled to begin as soon as October 1, 2013.

California is the fourth state to enter into an MOU with CMS to implement a dual eligible demonstration employing a risk-based capitated model, and Cal MediConnect represents the nation's largest, most aggressive plan for integration to date. Beginning in October, California will enroll up to 456,000 dual eligible individuals residing in eight California counties into managed care plans, who will be responsible for delivering all covered Medi-Cal and Medicare services to plan enrollees.  

 

NSCLC has prepared a brief summary of the California MOU outlining the key components of the demonstration. As this is now the fourth MOU approving a capitated program, the summary outlines key differences between the California MOU and the MOUs approved in other states.