Memo Points to Possible Mismanagement of CalOptima Health Plan

TOPIC ALERT:

An internal document obtained by Payers & Providers suggests that CalOptima -- Orange County's Medi-Cal managed care plan -- might be seriously mismanaged, Payers & Providers reports. Medi-Cal is California's Medicaid program.

The document was part of internal communications between the county's Board of Supervisors and Nicholas Chrisos, the county counsel.

Details of the Document

According to the document, Todd Theodora -- a special counsel to CalOptima -- hired health care consultant Arthur Shorr to conduct an evaluation of CalOptima's management, Payers & Providers reports.

Some of the conclusions that Shorr outlined in a Nov. 30 memo state that:

  • CalOptima's board and management are placing the organization at "risk for disaster" by not following compliance standards;
  • Board and management have not given the public health plan "strategic direction"; and
  • Board members gave executive compensation oversight to CEO Richard Chambers, thereby placing the funds at risk of "being manipulated."

CalOptima officials said they had not seen the memo and therefore declined to comment, according to Payers & Providers.  

CalOptima Restructuring

Meanwhile, the county Board of Supervisors this week approved a change to the organization's governance structure that will expand the number of board seats from 11 to 13. A rotating seat reserved for a hospital representative also was made permanent (Payers & Providers, 12/15).


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