|
Medi-Cal Transition of Dual Eligibles to Managed Care Plans
We have written previously about the DHCS plan to continue moving Medi-Cal enrollees to managed care. It is known as the Coordinated Care Initiative (CCI). They are one of several states that will operate under a CMS waiver to move dual eligible beneficiaries, those that are both Medi-Cal and Medicare eligible, into local managed care plans. Those could be county operated health systems or private plans like Anthem or HealthNet. Last year DHCS transitioned Seniors and Persons with Disabilities ( SPDs) and the plan was to have begun transitioning dual eligible in June of 2013 in a number of large counties.
In the Governor's proposed budget for 2013-14 released on 1/10/13 he announced a revised schedule for this transition that will delay implementation for all counties and in the case of LA county will actually extend the transition to 18 months rather than 12 months. Beneficiaries are transitioned in their birth month and typically receive a notice of the change 3 months prior to that. A beneficiary can choose to opt out of including their Medicare coverage into the managed care plan but must transition for the Medi-Cal portion. If a patient opts out they could continue their Medicare coverage in a Medicare Advantage plan or fee for service. DHCS must still gain CMS approval of the pilot elements so it is possible that there could be further delays. The specifics of the counties involved and the new projected start dates are as follows;
- Timeline. The proposed budget calls for implementing both parts of the CCI, the duals demonstration and transition to managed care for Long Term Supports and Services in September 2013.
- This means that the first notices that any beneficiaries would receive about these transitions would come no earlier than June 2013.
- Enrollment Phase-in. There are eight counties in the CCI: Alameda, Los Angeles, San Bernardino, San Diego, San Mateo, Santa Clara, Orange and Riverside. According to the budget announcement:
- In Los Angeles County, enrollment will phase in over 18 months.
- In San Mateo, enrollment will occur all at once in September 2013.
- For all other counties, enrollment will phase-in over 12 months.
CRS is Looking for Volunteers to Serve as ACR Alternate Councilors
The CRS is apportioned a number of councilors and alternate councilors by the ACR to serve as representatives to the ACR Council. The Council meets annually during the ACR meeting in Washington, DC
this year on May 4-8, 2013. ACR councilors and alternates are also members of the CRS Executive Committee that in addition to meeting during the ACR Washington meeting will also meet two additional times per year in March and September.
The CRS currently allots councilor and alternate councilor positions to the various local radiological societies and also has some at-large positions. If you have an interest in serving as an alternate councilor beginning this year please email Bob Achermann, CRS Executive Director, at bachermann@amgroup.us. It's an opportunity to stay informed about the changes effecting diagnostic radiology, radiation oncology and interventional radiology and to help shape the response of organized radiology to these challenges.
Save the Date California Radiological Society Executive Committee Meeting & Legislative Appointments
March 17-18, 2013
Sheraton Grand Sacramento Hotel
Sacramento, CA
|
