California Healthline: Duals Demonstration Project Begins

by David Gorn

The duals demonstration project launched last week in five counties, according to officials from the Department of Health Care Services, which is overseeing the project.

Only one county has launched the automatic process — known as passive enrollment — that moves beneficiaries into new coverage. In San Mateo County, residents who are dually eligible for Medicare and Medi-Cal and who do not choose the Medi-Cal fee-for-service option will be automatically — or passively — enrolled in Medi-Cal managed care.

Three other counties (Riverside, San Bernardino and San Diego) will begin passive enrollment next month.

Los Angeles County is slated to start passive enrollment in July, though LA Care, one of the larger providers in the county, will not passively enroll dual eligibles until January 2015. LA Care passed its CMS readiness review so the insurer is able to accept dual eligibles who voluntarily enroll, but LA Care’s low marks in the CMS star rating system will prevent it from automatic enrollment till 2015.

Three other counties — Alameda, Orange and Santa Clara — are scheduled to participate in the project starting in January 2015.

The duals demonstration project, known as Cal MediConnect, is part of the state’s Coordinated Care Initiative.

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