DHCS Proposes New MCP Contract with Kaiser Permanente
The California Department of Health Care Services (DHCS) recently released a proposal to enter into a direct contract with Kaiser Permanente as a Medi-Cal managed care plan within new geographic regions of the state, effective January 1, 2024, for a five-year contract term with potential contract extensions. Under the new proposed contract, subject to federal approvals, Kaiser Permanente would operate as a full-risk, full-scope Medi-Cal managed care plan, consistent with other Medi-Cal managed care plans.
The proposed arrangement would allow Kaiser Permanente to bypass the state’s recently announced MCP RFP process. Kaiser Permanente would no longer be granted specific exceptions or alternative standards. The only exception, according to DHCS, will be that Kaiser Permanente will not be open through the traditional Medi-Cal plan choice methods.
DHCS is proposing trailer bill language to clarify its statutory authority to maintain and expand direct, full-risk contracts with Kaiser Permanente. Subject to federal approval, direct contracts would be available in any geographic areas in which Kaiser Permanente operates, including COHS/single plan model counties, two-plan model counties, regional model counties, and Geographic Managed Care model counties.
Additional information from DHCS is available here.