California Heathline: Yamada Takes a Lonely Stand on ADHC Bill
by David Gorn The Senate Committee on Health yesterday rejected a bill designed to perpetuate adult day health care services in one of the strangest votes in recent memory. The legislators on the committee voiced strong support for the bill and said they wanted to vote for it, but bill author Assembly member Mariko Yamada … Read more
NY Times: Day Centers Sprout Up, Luring Fit Elders and Costing Medicaid
By NINA BERNSTEIN Published: April 22, 2013 Scores of elderly Russian immigrants played bingo under the chandeliers of a former funeral parlor in Brooklyn on a recent Monday, with a free dinner and door-to-door transportation from anywhere in the city. Nearby, older people speaking Chinese filled a supermarket-size storefront with vigorous games of table tennis, billiards … Read more
Medi-Cal Update Community – Based Adult Services (formerly Adult Day Health Care Centers)
March 2013 | Bulletin 462 Contents Community-Based Adult Services: Recipient Eligibility Determination Subscribe Today to Receive Medi-Cal Notifications via Email End Date for ASC X12N 4010A1 and NCPDP 5.1/1.1 Transactions CMC Error Messages for HIPAA 4010 Transactions Solutions for Denied MERs from Mandatory Enrollment into a Medi-Cal Managed Care Plan Authorized Drug Manufacturer Labeler Codes … Read more
California Healthline: State Delays Adult Day Center Not-for-Profit Requirement
by David Gorn The requirement that adult day health care centers become not-for-profit operations has been delayed at least a year, according to Department of Health Care Services officials. A Dec. 31 letter to centers caring for the frail and elderly population in the Community Based Adult Services program said “DHCS has decided to postpone … Read more
LA Times: State sued over Medi-Cal patients’ switch to managed care
The lawsuit says the recipients’ rights were violated and they lost access to their doctors in the transition. December 23, 2012|By Anna Gorman, Los Angeles Times Legal aid organizations filed a lawsuit Friday against the California Department of Health Care Services, alleging that the state violated patients’ rights by forcing them into managed care. The … Read more
California Healthline: Time Running Out To Opt Back In to Adult Day Program
by David Gorn About 4,400 frail and elderly Californians who qualified for Community Based Adult Services opted out of the managed care program to remain in traditional fee-for-service care. Less than three weeks remain for them to change their minds. On Dec. 31, the state Easy-Way-Back program will close, and those “opt-outs” who declined Medi-Cal … Read more
California Healthline: Duals Project Edges Closer to Completion
by David Gorn More than 300 people attended a Department of Health Care Services seminar yesterday offering details of the duals demonstration project, also known as the Coordinated Care Initiative. The department recently released several reports, including a draft of the care coordination and long-term services and supports readiness standards. Those guidelines are a big … Read more
California Healthline: State’s Dual Eligibles Initiative Under National Spotlight
Patient advocates across the U.S. are closely watching California’s transition of beneficiaries eligible for both Medicare and Medi-Cal from traditional fee-for-service plans to managed care plans, Kaiser Health News reports. Medi-Cal is California’s Medicaid program. Background The California initiative is in its second year. State officials seek to transfer so-called dual eligibles to managed care plans to … Read more
California Healthline: Higher Primary Care Rate Welcome News for California
by David Gorn Earlier this month, CMS made it official: The federal government will pay Medi-Cal primary care physicians in California at the same rate as Medicare in 2013 and 2014. The higher rate, confirmed by CMS officials on Nov. 2, means more than just paying more to family practice, pediatrics and internal medicine physicians, … Read more
CDCAN: Brown Administration releases draft documents for public comment on implementing Medi-Cal’s “Coordinated Care Initiative”
BROWN ADMINISTRATION RELEASES FOR PUBLIC COMMENT DRAFT DOCUMENTS FOR IMPLEMENTING MASSIVE CHANGES TO MEDI-CAL NEXT YEAR CALLED “COORDINATED CARE INITIATIVE” Part of 2012-2013 State Budget and Would Initially Cover 8 Counties (Alameda, Los Angeles, Orange, San Bernardino, San Diego, San Mateo, Santa Clara and Riverside Counties) – Eventually Entire State by 2015 Coordinated Care Initiative … Read more
