CHA News Article

All Plan Letter Addresses Long-Term Care Coordination, Disenrollment

The Department of Health Care Services has released the attached All Plan Letter clarifying Medi-Cal managed care health plans’ requirements related to long-term care for beneficiaries. First, the letter describes the requirement that plans coordinate the care and placement of beneficiaries who require long-term care in certain facilities including skilled-nursing, subacute, pediatric subacute and intermediate care. The letter further clarifies that plans are required to initiate disenrollment when the provision of long-term care is no longer a contractual obligation for the plan, such as when a beneficiary requires long-term care for longer than one month after the month of admission.

The guidance also outlines requirements for submitting disenrollment requests, and reminds plans that they are required to provide all medically necessary covered services until the Department of Health Care Services approves the disenrollment.

CHA previously submitted comments on the draft All Plan Letter.