CalDuals: Enrollment Materials

Final Notices and Materials This section contains the notices for the program. Notices will be sent in blue envelopes. Click here to see a color swatch of the envelopes.  Final Cal MediConnect Notices and Guidebook The following are template notices that will be customized for different enrollment populations, such as beneficiaries in a Dual Eligibles Special Needs … Continue reading

NSCLC: Advocates Recommend Ways to Measure Rebalancing In Managed LTSS and Dual Eligible Demonstrations

Consumers, providers, regulators and policymakers generally agree that rebalancing long-term services and supports (LTSS) system towards greater use of home and community-based services versus institutional care is a shared goal as states shift to the use of managed LTSS for those older adults and persons with disabilities with Medicare and Medicaid (dual eligibles) and others … Continue reading

NSCLC: CMS Releases Guidance for Enrollment Practices in the Dual Eligible Demonstration Projects

From our colleagues at NSCLC:    The Medicare-Medicaid Coordination Office at CMS recently released final enrollment guidance for the dual eligible financial alignment demonstration projects that are being planned by about 20 states. The guidance sets standards for passive and voluntary enrollment, including notice requirements. It contains a model application form and 30 different model … Continue reading

California Healthline: 5.3M Californians Drew Government Assistance in 2011, Report Finds

About 5.3 million California residents in 2011 received income-based government assistance — including health insurance benefits through Medi-Cal — according to a Census Bureau report, the Sacramento Bee‘s “Capitol Alert” reports (Walters, “Capitol Alert,” Sacramento Bee, 2/26). Medi-Cal is California’s Medicaid program. National Findings The report found that about 46 million U.S. residents received income-based government assistance in … Continue reading

NCPSSM: Here they go again: the Latest Bowles Simpson Proposal tells Seniors “Pay More and Get Less”

John William Springs, a retiree who gets nearly $12,000 a year in Social Security and disability checks, is $1,300 above the poverty threshold: officially, not poor.

“The latest Bowles-Simpson plan to tackle the nation’s debt offers nothing more than a repackaged proposal to cut to Social Security, Medicare and Medicaid through measures such as the chained CPI, means testing Medicare and raising the eligibility age. Yet, America’s seniors, the disabled, veterans and their families have already rejected these proposals through hundreds of … Continue reading

CDCAN: CDCAN REPORT #004-2013: Governor proposes delaying dual eligible demonstration project to September 2013 in a “phase in” approach,0,827936.story

Submitted by Marty Omoto on Thu, 01/10/2013 – 10:30am GOVERNOR PROPOSES DELAYING IMPLEMENTATION OF “DUAL ELIGIBLES” DEMONSTRATION PROJECT TO SEPTEMBER 2013 – NO NEW CUTS PROPOSED FOR IHSS, HEALTHY FAMILIES – 3.6% EXISTING IHSS CUT WILL END AS SCHEDULED JUNE 30, 2013 Proposes That 8 County Demonstration Project Be Implemented Under A “Phased In” Approach Beginning In September … Continue reading

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 … Continue reading

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 … Continue reading

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 … Continue reading

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 … Continue reading

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