Coordinated Care Initiative (CCI) Update March 31, 2014 CMA, Medi Cal, Medicare, Physician Resource CCI, Dual Eligibles, Medi-Cal, Medicare 0 The Coordinated Care Initiative (CCI) allows persons eligible for both Medicare and Medi-Cal (dual eligibles) to receive medical, behavioral, long-term supports and services (LTSS), as well as home-and community-based services through a single health plan. The CCI has been implemented in eight counties (Alameda, Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Mateo, and Santa Clara). The state recently began mailing notices to dual beneficiaries about their options regarding the duals demonstration. Three separate notices will be mailed out before the start of the passive enrollment period: 90-day notice: Will alert beneficiary to the implementation of the duals demonstration program. 60-day notice: Will contain information about plan benefits and provider networks to help beneficiary select a plan. Notices have already been sent to patients in Riverside, San Bernardino, and San Diego counties. 30-day notice: Will provide beneficiary with information about his or her specific plan; if patient has not selected a plan, the state will assign one. To give patients the opportunity to opt out of the Cal MediConnect program, the state plans to send a “choice form” in conjunction with the health plan guidebook. Both will be mailed after the 60-day notice, but before the 30-day notice. The choice form will allow patients to either select a plan for Cal MediConnect or a Medi-Cal only plan, which is mandatory for this population. As these forms are neither simple nor clear for patients to fill out, CMA has voiced their concerns to the Department of Health Care Services. CMA has also developed resources to help physicians explain to patients about their options regarding participation in the CCI including a fact sheet explaining the opt-in and opt-out process of the demonstration and patient letters that physicians can use as a guide when discussing Cal MediConnect with patients. General Information Duals Web Page Fact Sheet Patient letters Contracting physicians Non-Contracting physicians PACE patients Comments are closed.
