CHA News Article

CHA Comments on Revised Enrollment Strategy for Cal MediConnect in LA County

CHA has submitted the attached comments to the Centers for Medicare & Medicaid Services (CMS) and the California Department of Health Care Services (DHCS) regarding the revised enrollment strategy for Los Angeles County dual eligible beneficiaries into Cal MediConnect beginning in April 2014. CHA continues to raise concerns regarding access and network adequacy that, if not addressed, may undermine the success of the demonstration. Among CHA’s concerns under the revised enrollment strategy is that it relies exclusively on the Health Net network for passive enrollment for a five-month period.

CHA is also concerned that the enrollment strategy presumes that LA Care will receive its CMS star rating and, therefore, plans enrollment accordingly without provisions for what will occur in the event that the necessary star rating is not achieved for 2015. CHA recommends that passive enrollment begin only after both health plans have met the necessary criteria to proceed to limit the potential for unintended consequences.  Further, CHA urges DHCS to consider more county-specific communications directly with hospitals during the opt-in and passive enrollment periods beginning in April 2014.