About Medi-Cal
Every year, California’s hospitals treat millions of patients, many of them covered by Medi-Cal, the state’s health care safety net. This includes numerous essential health care services for Californians, including care for more than 50% of all births, 46% of behavioral health-related emergency department visits, 58% of rural hospital patient care days, 1 million inpatient stays, and nearly 16 million outpatient visits in 2018. CHA is committed to protecting Medi-Cal rates and assuring that the state’s neediest maintain access to the high quality of care that all Californians deserve.
5 Things To Know: Ballot Initiative
BALLOT INITIATIVE WOULD DEDICATE MCO TAX REVENUE TO FUND MEDI-CAL: The Coalition to Protect Access to Care has submitted more than 800,000 voter signatures to qualify the Protect Access to Healthcare initiative for California’s November 2024 ballot. CHA supports the proposed ballot measure, which would permanently channel managed care organization (MCO) tax revenue to Medi-Cal providers such as hospitals, physicians, women’s health and community clinics, and health centers. To help build support, the coalition has created a toolkit, which includes a sample newsletter that can be adapted for various audiences, sample social posts and graphics, and links to fact sheets.
5 Things To Know: Default Enrollment Pilot
MEDICARE MEDI-CAL PLANS – DEFAULT ENROLLMENT PILOT: This summer, the Department of Health Care Services (DHCS) will launch a default enrollment pilot for select Medicare Medi-Cal (Medi-Medi) Plans in San Diego and San Mateo counties. Medi-Medi Plans are a type of Medicare Advantage (MA) plan that coordinates all benefits and services across both programs for dually-eligible individuals. Under the pilot, when a managed care plan (MCP) member becomes eligible for Medicare due to age or disability, they will automatically be enrolled in the Dual Eligible Special Needs Plan (D-SNP) for that MCP, unless the member chooses a different Medicare option, such as Original Medicare or another MA plan. The Centers for Medicare & Medicaid Services included guidance on D-SNP default enrollment in its annual MA Enrollment and Disenrollment Guidance. Please contact DHCS at info@calduals.org with any questions or comments about Medi-Medi Plans
5 Things To Know: Webinar Trainings
TRAINING SET FOR CHILDREN’S PRESUMPTIVE ELIGIBILITY AND NEWBORN GATEWAY: Medi-Cal’s outreach and education team and the Department of Health Care Services will host overview trainings on Children’s Presumptive Eligibility and Newborn Gateway. The live webinar trainings will be conducted on May 29 at 10 a.m. (PT) and June 6 at 1 p.m. (PT) and will be recorded. Providers must register through the Medi‑Cal Learning Portal.
5 Things To Know: CalAIM Provider Forums
CALAIM PROVIDER FORUM MEETINGS TO BE HOSTED IN MAY: California Advancing and Innovating Medi-Cal (CalAIM) provider forums are designed to give current and prospective providers of enhanced care management and community support services the opportunity to share experiences, ask questions, and learn from one another. Upcoming forums will be hosted for Imperial County on May 2 at 1 p.m. (PT) and San Diego County on May 9 at 11 a.m. (PT).
5 Things To Know: Study Finds CA Bridge Program is Highly Effective, Funding to Continue; San Diego TB Prevention Education and Community Engagement Summit; San Diego Workforce Partnerships Substance Use Counselor Program; DHCS Publishes Quality Ratings for Managed Care Plans and County Behavioral Health Plans; Medicare Coverage for Behavioral Health Expanded
STUDY FINDS CA BRIDGE PROGRAM IS HIGHLY EFFECTIVE, FUNDING TO CONTINUE: JAMA Network recently published a study highlighting the impact of the CA Bridge Program on opioid use disorder (OUD) treatment in emergency departments (EDs). The study found that 86% of OUD patients received buprenorphine in participating hospitals, with 50% continuing treatment 30 days after […]
5 Things To Know: San Diego City Council Declares Behavioral Health Bed Crisis, County of San Diego Emergency Medical Services, San Diego County Releases Draft APOT Policy, CDPH Releases New AFL on Covid-19 Vaccinations,CHA Releases FAQs on Implementing AB 1882 Requirements
SAN DIEGO CITY COUNCIL DECLARES BEHAVIORAL HEALTH BED CRISIS: On Dec. 5, the San Diego City Council declared a behavioral health crisis due to the lack of available behavioral health beds in the city. A recent survey of hospital members found that on any given day in the HASD&IC region, about 50 patients who are […]
5 Things To Know: Medi-Cal Redeterminations, Covid-19 Precautions, National Recovery Month, Timely Claims Payments, HCAI Seismic Webinars
MEDI-CAL REDETERMINATIONS: The Department of Health Care Services has published a new interactive dashboard detailing statewide and county-level demographic data on Medi-Cal application processing, enrollments, redeterminations, and renewal outcomes. Preliminary data on the Medi-Cal redeterminations show that in San Diego County, 16,336 Medi-Cal beneficiaries were disenrolled effective June 30. In Imperial County, 1,482 beneficiaries were […]
5 Things To Know: Medi-Cal Managed Care Plan Transition, Information Needed, National Minority Mental Health Awareness Month, Avian Flu, County Budget
MEDI-CAL MANAGED CARE PLAN TRANSITION: The Department of Health Care Services (DHCS) has released an All Plan Letter that provides guidance to all Medi-Cal managed care health plans (MCPs) regarding the 2024 MCP Transition, which is effective Jan. 1, 2024. In addition, DHCS has developed the 2024 Managed Care Plan Transition Policy Guide, which establishes and details the requirements for the implementation of the 2024 MCP Transition. The Policy Guide was initially published in May 2023 and will continue to be updated throughout 2023. All updates will be specifically identified in a dedicated section in the Policy Guide and will outline updates from prior versions in order to manage version history. The Policy Guide, which is also available on the DHCS 2024 MCP Transition web page, will denote effective dates and end dates, if applicable, to the specific policies contained therein.
5 Things To Know: Medi-Cal Enrollment Systems and Disenrollments, White Paper, Supplier Diversity Reports, Overdose Prevention And Outreach, EMS System Plan
MEDI-CAL ENROLLMENT SYSTEMS AND DISENROLLMENTS: The current enrollment system (MyBenefits CalWIN) that hospitals, clinics, schools, and social service providers use to connect San Diegans to CalFresh and Medi-Cal will shut down on June 29. The new system, BenefitsCal, will not be available until July 3. As a result, hospitals will have to use alternate methods for assisting patients with Medi-Cal applications between June 29 and July 3. July 1 is also the first month that Medi-Cal beneficiaries will be disenrolled if they didn’t renew their coverage. Please reach out to Lindsey Wade at lwade@hasdic.org with any questions or concerns.
5 Things To Know: Transitions Of Care Sub Workgroup, Feedback Sought, Behavioral Health Scholarships, Cybersecurity, Webinar
TRANSITIONS OF CARE SUB WORKGROUP: The county of San Diego, along with the Legal Aid Society of San Diego and HASD&IC, helped establish a sub workgroup of the Healthy San Diego Dual Eligible/Long Term Services & Supports (LTSS) Workgroup — the Transitions of Care Sub Workgroup. The Sub Workgroup will focus on pressing matters caused by the gaps and challenges in keeping older/disabled adults receiving Medi-Cal connected to quality care and LTSS. The focus is on access to LTSS for older adults and the regional work around the dually eligible beneficiaries, and transitions of care, whether moving from the community or back into the community, and care coordination by the payer, including the providers and caregivers. If you or someone from your organization is interested in joining, please contact Caryn Sumek at csumek@hasdic.org.