Timeline Delineates Duals Project Tasks

by David Gorn

TOPIC ALERT:

The state Department of Health Care Services has released a timeline of deadlines and target dates for its Coordinated Care Initiative, also known as the duals demonstration project.

Eventually, the duals project hopes to move about one million Californians dually eligible for Medi-Cal and Medicare benefits into Medi-Cal managed care plans. The idea, state officials have said, is to provide better, more integrated care by pooling the funding sources from two disparate programs. Coordinated care could provide stronger case management, offer needed services and save state and federal dollars.

The pilot program in eight counties, beginning in March, 2013, will serve about 700,000 of the state's dual eligibles.

http://A number of unresolved issues need to be worked out over the next month or so. For one, the state has been insisting on a six-month enrollment period, during which enrollees cannot opt out. CMS officials have balked at that idea. The two agencies are working on a memorandum of understanding -- known as an MOU -- and are expected to reach agreement next month.

The other big decision is whether to start enrollment all at once, or to stagger it -- with part of it in March, and another part in June. The state is currently soliciting public input on the subject (and other issues), in the form of stakeholder workgroups through August.

"Everyone knows the big one is the MOU process," said Peter Harbage of Harbage Consulting, which is working with the state to help solicit stakeholder input. "The key document is going to be the MOU."

According to the timeline, the state will work with CMS to finalize the MOU, complete the quality and fiscal measures for the plan and submit an update of California's 1115 Medicaid waiver by the end of August.

"It's all underway," Harbage said. "There is certainly a lot of information to get and process. It's a process."


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