Medi-Cal Continuity of Coverage Policy Change

Last week, the DHCS announced that the department will continue existing state-funded full-scope Medi-Cal coverage for individuals who turn age 26 until the Medi-Cal expansion of people ages 26-49 takes effect on January 1, 2024. This policy change is being implemented in order to maintain continuity of coverage for individuals who turn age 26 during this gap period – even after the public health emergency ends.

DHCS has produced an Operational Unwinding Plan that you can find here, which also discusses telehealth after the termination of the public health emergency (PHE) as well as several other behavioral health issues post-PHE.

Medi-Cal Managed Care Plan Contract – Statement of Work

Grateful to our friends at the California Hospital Association (credit where credit is due), who made sure folks are aware of “…the new DHCS RFP to procure contracts with commercial health plans able to provide health care services to Medi-Cal beneficiaries (including but not limited to parity requirements, mild/moderate outpatient MH, enhanced care management, community supports, emergency department services, transportation, etc.). The “Primary Contract” attached describes federally funded services, and the “Secondary Contract” describes state-funded services. The list of plans announced by DHCS are here, with anticipated implementation of this new 5-year contract starting on January 1, 2024: https://www.dhcs.ca.gov/CalAIM/Pages/MCP-RFP.aspx.
Here’s the list, by county: https://www.dhcs.ca.gov/provgovpart/rfa_rfp/Documents/NOIA-MCP-2010029.pdf.
Note this is only for plans/counties with the Two-Plan Model, Geographic Managed Care (GMC), and Regional Model.”

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