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NSCLC: New Issue Brief Unfinished Business: Designing Appeals Procedures in the Dual-Eligible Demonstrations

From our colleagues at NSCLC: Under the Affordable Care Act, a number of states are participating in financial alignment demonstrations that combine the delivery of Medicare and Medicaid services for dual eligible beneficiaries. Even though financial alignment demonstrations are already “live” in five states with tens of thousands receiving services through demonstration plans, the appeal … Continue reading

California Healthline: What’s Behind High Opt-Out Rate Among Dual Eligibles in L.A. County?

by David Gorn he state’s duals demonstration project has hit a rough patch in Los Angeles County. Health officials are in the middle of an effort to enroll a large segment of the state’s dual-eligible population in Cal MediConnect — a seven-county pilot project designed to coordinate care and funding for about 430,000 Californians who … Continue reading

California Healthline: State Tweaks Timeline for Duals Project

by David Gorn State health officials last week dropped Alameda County and its 26,000 dual-eligibles from Cal MediConnect, California’s demonstration project for Californians eligible for Medi-Cal and Medicare. The timeline for Orange County was pushed back one month for automatic enrollment to start. Orange County had already been delayed to start no sooner than July … Continue reading

California Healthline: Mixed Bag So Far for Duals Program: Some Glad, Some Livid, Most Confused

Oct 31- ADHC Rally photo (Photo credit: Steve Lopez)

In a California Healthline report by Rachel Dornhelm, experts discussed the promise and pitfalls of the state’s rollout of Cal MediConnect, which offers 456,000 Californians who are dually eligible for Medicare and Medi-Cal a new pilot program of coordinated care through a Medi-Cal managed care plan. The state is about halfway through the passive enrollment process and, … Continue reading

California Healthline: Duals Project Sign-Ups Hit Halfway Mark

About 7,100 Californians signed up daily for private health insurance in the state's exchange during the first week of December, data show. (David McNew / Getty Images) http://www.latimes.com/business/healthcare/la-fi-mo-covered-california-enrollment-20131212,0,5700327.story#ixzz2nNcmjrOg

by David Gorn BREAKING NEWS: Advocates have dropped their effort to seek a preliminary injunction in federal court to halt the duals demonstration project, in part citing “procedural difficulties.” The state has sent enrollment notices to almost half the 456,000 people eligible for California’s duals demonstration project. So far, about 36% have opted to be … Continue reading

California Healthline: New Lawsuit Filed To Block Duals Plan

by David Gorn Advocates for seniors filed a lawsuit in United States District Court in Los Angeles last week seeking an injunction to halt the Coordinated Care Initiative’s duals demonstration project, known as Cal MediConnect. The project plans to move 456,000 seniors dually eligible for Medi-Cal and Medicare benefits into Medi-Cal managed care plans in … Continue reading

NSCLC: Understanding the Duals Special Needs Plan Policy

From our colleagues at NSCLC: The California Department of Health Care Services (DHCS) recently released a new Duals Special Needs Plan (D-SNP) policy impacting beneficiaries residing in counties implementing the Coordinated Care Initiative (CCI). The new policy is complicated and affects beneficiaries enrolled in Medicare Advantage plans differently than beneficiaries in fee-for-service Medicare.  The National … Continue reading

California Healthline: State Wins Duals Project Court Ruling, Medicaid Defense Fund Plans to Appeal

by David Gorn A California Superior Court judge’s decision Friday that the state may continue its demonstration project for dual eligibles could affect up to 456,000 Californians who are eligible for both Medicare and Medi-Cal — roughly half of the state’s 1.1 million duals. The duals in certain counties are part of the state’s Cal MediConnect … Continue reading

California Healthline: Judge Delays Duals Injunction Decision

A California Superior Court hearing last week in Sacramento — to determine whether or not to issue an injunction to stop the state’s duals demonstration project — came to a quick end, before it even really started. “I don’t feel entirely comfortable issuing a ruling today,” said Superior Court judge Shelleyanne Chang at the opening … Continue reading

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