The state Department of Health Care Services (DHCS) has released
a Request for Application (RFA) seeking health plans and
nonprofits interested in providing Medi-Cal Managed Care in 25
rural counties.
The RFA comes in response to legislation passed this year (AB
1467) that authorized the state to seek health plans and
nonprofits to provide Medi-Cal Managed Care in the majority of
the remaining Medi-Cal Fee-for-Service (FFS) counties (Lake, San
Benito, and Imperial Counties are exempt from this policy). The
counties that will be transitioned from FFS to Managed Care are
Alpine, Amador, Butte, Calaveras, Colusa, Del Norte, El Dorado,
Glenn, Humboldt, Inyo, Lassen, Mariposa, Modoc, Mono, Nevada,
Placer, Plumas, Shasta, Sierra, Siskiyou, Sutter, Tehama,
Trinity, Tuolumne, and Yuba Counties. The transition is slated to
begin in June of 2013, and the formal RFA is the second step in
the process.
Interested parties must submit a letter of intent to apply no
later than November 19, and the application deadline is January
21, 2013. To view the RFA or background on the managed care
expansion to rural counties, click here.
State Releases Healthy Families Program Network Adequacy
Assessment
The state Department of Health Care Services (DHCS) submitted the
Phase 1 Network Adequacy Assessment Report on the transition of
Healthy Families Program (HFP) children into the Medi-Cal program
to the Legislature this week.
The report was required 60 days prior to the anticipated start of
the transition, which is still slated for January 1, 2013. The
transition of about 800,000 HFP participants to Medi-Cal in 2013
will occur in four phases, but questions about the availability
of Medi-Cal providers willing to accept lower reimbursement rates
for the former HFP children, as well as concerns about
eligibility, enrollment, and renewals for the existing HFP
clients, may delay the January 1 transition start date.
Comments on the network adequacy report are due Friday, November
16, and may be submitted to
dhcshealthyfamiliestransition@dhcs.ca.gov . Please note that this
network adequacy report does not include data regarding mental
health or substance abuse disorder providers, as the state is
still gathering that data. For information about the HFP
transition to Medi-Cal, click here.
