CHA News Article

DHCS Selects Health Plans for Expansion of Medi-Cal Managed Care to 28 Rural Counties
Services will be provided to more than 400,000 Medi-Cal members

The Department of Health Care Services (DHCS) announced yesterday it has selected four health plans to provide managed care services to more than 400,000 Medi-Cal members in 28 rural counties, expanding Medi-Cal managed care to all of California’s 58 counties. The selections are contingent upon each plan meeting stringent readiness criteria. Anthem Blue Cross and California Health and Wellness Plan were selected for the Medi-Cal managed care expansion to Alpine, Amador, Butte, Calaveras, Colusa, El Dorado, Glenn, Inyo, Mariposa, Mono, Nevada, Placer, Plumas, Sierra, Sutter, Tehama, Tuolumne and Yuba counties. To serve Medi-Cal beneficiaries in Del Norte, Humboldt, Lassen, Modoc, Shasta, Siskiyou and Trinity counties, the state is planning an exclusive Medi-Cal managed care contract with Partnership HealthPlan of California. Each of these seven counties secured County Board of Supervisors’ resolutions in support of their county beginning Medi-Cal managed care with the County Organized Health System (COHS) model. In addition, Lake and San Benito counties would become COHS managed care counties served by Partnership HealthPlan of California and Central California Alliance for Health. DHCS is currently working with Imperial County on its managed care plan selection process.

The 2012-13 state budget authorized the expansion of Medi-Cal managed care to rural California counties in which members currently receive services on a fee-for-service (FFS) basis. Beginning June 1, 2013, approximately 410,000 Medi-Cal members will be transitioned to managed care in the 28 rural counties. The cost of this expansion cannot exceed the total amount that DHCS estimates it would pay for services under the FFS Medi-Cal program, and DHCS must seek and receive all necessary federal approvals before the expansion is implemented.

For more information on Medi-Cal Managed Care Rural Expansion, visit: www.dhcs.ca.gov/provgovpart/Pages/MMCDRuralExpansion.aspx.

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