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DHCS Announces Coverage Changes for Medi-Cal Managed Care Plans, Coordinated Care Initiative

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The Department of Health Care Services (DHCS) has announced it will make long-term care and transplant coverage the responsibility of all Medi-Cal managed care plan model types — including Two Plan, Geographic Managed Care, Imperial, Regional, and San Benito — effective Jan. 1, 2021. These benefits are currently carved in to County Organized Health Systems, and no changes will be made for them. 

The department also plans to carve out the Multipurpose Senior Services Program (MSSP) benefit from the Coordinated Care Initiative (including managed long-term services and supports managed care plans and Cal MediConnect plans) in all seven counties of operation: San Mateo, Los Angeles, Orange, Riverside, San Bernardino, San Diego, and Santa Clara.

In these counties, beginning in 2021, MSSP will operate as a waiver benefit, as it did prior to implementation of the Coordinated Care Initiative in 2014.

Additional information is included in the announcement from DHCS, with additional details to follow in the near future. Questions can be submitted to DHCS at CalAIM@dhcs.ca.gov.