DHCS Issues Guidance for Counties Interested in Changing Medi-Cal Managed Care Plan Models
This week, the California Department of Health Care Services (DHCS) released instructions for counties interested in changing Medi-Cal Managed Care (MCMC) models. In 2021, DHCS will begin a statewide procurement process for commercial MCMC plans. Multiple counties have expressed interest in transitioning to a MCMC model that includes a local plan. If a county transitions to a model that includes a local plan, DHCS may remove that county from the commercial plan procurement (for a single local plan model) or reduce the number of commercial plans procured in the county (for a Two-Plan Model).
DHCS, in its letter, provides instructions for a county and managed care plan letter of intent to transition models that is due March 31, 2021. The DHCS guidance provides information on required data and materials to be included as part of the letter of intent process. Of particular note, failure to submit a complete letter of intent will preclude a county from shifting to a local plan model by January 2024.
Additional information and details are available here.