Practices encouraged to take DHCS Medi-Cal provider satisfaction survey The Department of Health Care Services (DHCS) is conducting a customer service satisfaction survey for Medi-Cal providers. The purpose is to determine the effectiveness of the program's provider relations activities, including the telephone service center, cash control unit, regional representatives, publications and provider seminars/trainings. The survey is completely confidential and anonymous. Your responses to will help Medi-Cal understand how providers can be better supported, and will shape future customer service improvement efforts. The survey will take approximately 20 minutes to complete and will be open until September 6, 2016. Click here to ... August 12, 2016 Medi-Cal Medi-Cal, DHCS 0 0 Comment Read More »
New online Medi-Cal provider enrollment portal launch planned for October 2016 The California Department of Health Care Services (DHCS) plans to launch its new Medi-Cal provider enrollment system in October. The Provider Application and Validation for Enrollment (PAVE) system will transform provider enrollment from a manual paper-based process to a web-based portal that providers can use to complete and submit their applications and verifications and to report changes. PAVE will improve the provider enrollment experience by minimizing errors, improving the application process and significantly reducing the time required to process provider enrollments. Testers needed DHCS is seeking Medi-Cal fee-for-service providers who are ... August 9, 2016 Medi-Cal Medi-Cal Provider Enrollment, Medi-Cal 0 0 Comment Read More »
Provider participation in Medi-Cal does not keep pace with growth of enrollment New 2015 data shows that the percentage of physicians participating in Medi-Cal has declined since 2013, while during the same period, Medi-Cal enrollment increased by 39 percent. The numbers show that provider participation in Medi-Cal has not kept pace with the growth in enrollment, and raise serious concerns about whether the numbers of physicians participating in Medi-Cal can meet the increased demand. A California Healthcare Foundation survey of California physicians shows that Medi-Cal participation declined from 69 percent in 2013 to 63 percent in 2015. The numbers of specialty care ... August 5, 2016 Medi-Cal Prop. 55, Prop. 56 (tobacco tax), Tobacco Tax, Medi-Cal, Political Advocacy 0 0 Comment Read More »
DHCS issues new beneficiary card design To commemorate Medi-Cal’s 50th anniversary, the Department of Health Care Services (DHCS) has introduced a new design for the Benefits Identification Card (BIC) for Medi-Cal beneficiaries. This new design, featuring the California poppy, will be provided to newly eligible recipients and recipients requiring replacement cards. There are no plans to provide the new card to the entire Medi-Cal population. Physicians are advised that both the old and the new card (to see both designs, click here) should be accepted by providers. Physicians are reminded, however, that they should continue to ... June 8, 2016 Medi-Cal Medi-Cal 0 0 Comment Read More »
Physicians advised to check enrollment status of pregnant patients insured by Covered California In April, news broke that nearly 2,000 pregnant women with Covered California health plans were automatically – and without their knowledge or consent – transferred from their exchange plan to Medi-Cal, even though they were supposed to have the option to stay with Covered California. The problem, attributed by Covered California partly to a computer glitch, can be traced to a recent policy change. Usually, consumers are placed in either Covered California or Medi-Cal based on their income, with no choice in the matter. But the rules are different for some ... June 8, 2016 Managed Care, Medi-Cal Covered California, Medi-Cal, Women's Health 0 0 Comment Read More »
DHCS suspends planned passive enrollment for duals project The Department of Health Care Services (DHCS) announced last week that it would not move forward with its planned annual passive enrollment of dual eligible beneficiaries under the Coordinated Care Initiative (CCI) after it received feedback from the California Medical Association (CMA) and 40 other stakeholders asking the agency to pursue enrollment strategies that support voluntary "opt-in" enrollment. Instead, DHCS said it will implement a voluntary "opt-in" enrollment effort beginning in July 2016. The new streamlined enrollment strategy will include mandatory Managed Medi-Cal Long-Term Supports and Services (MLTSS) plan enrollment. ... June 8, 2016 Managed Care, Medi-Cal, Medicare Medi-Cal, Medicare, Cal-MediConnect, Department of Health Care Services, Dual Eligible 0 0 Comment Read More »
CMA opposes proposed changes to duals demonstration The Department of Health Care Services (DHCS) recently released a series of proposals that would change the Coordinated Care Initiative (CCI) enrollment process to 1) passively enroll beneficiaries into Cal MediConnect; and to 2) streamline enrollment by allowing plans to eliminate or dramatically reduce the role of the enrollment broker. The California Medical Association (CMA), in partnership with Justice in Aging and other patient advocacy groups, signed a joint letter strongly opposing the proposals. The Coordinated Care Initiative was authorized by the state in July 2012 in an effort to save ... April 28, 2016 General, Medi-Cal, Medicare Dual Eligible, Medi-Cal, Medicare, DHCS, Regulatory Advocacy 0 0 Comment Read More »
Reminder: Deadline to review Open Payments data is May 15 Drug and medical device manufacturers have completed their submission of data to the Open Payments system on payments or transfers of value made to physicians and teaching hospitals during 2015. Physicians and teaching hospitals now have until May 15, 2016, to review and dispute records attributed to them. The review and dispute process is voluntary, but encouraged. The Centers for Medicare and Medicaid Services (CMS) will publish the 2015 payment data and updates to the 2013 and 2014 data on June 30, 2016. Under the Sunshine Act, drug and medical device ... April 28, 2016 General, Medi-Cal, Medicare CMS, Physician Payments Sunshine Act, Centers for Medicare and Medicaid Services 0 0 Comment Read More »
CMS announces new primary-care payment and health care delivery model The Centers for Medicare and Medicaid Services (CMS) this week announced a new payment model aimed at transforming and improving how primary care is delivered and paid for in America. The Comprehensive Primary Care Plus (CPC+) model will be implemented in up to 20 regions and can accommodate up to 5,000 practices, which would encompass more than 20,000 doctors and clinicians and the 25 million people they serve. The initiative is designed to provide doctors the freedom to care for their patients the way they think will deliver the ... April 18, 2016 Medi-Cal, Medicare Medicare, Centers for Medicare and Medicaid Services 0 0 Comment Read More »
Open Payments review and dispute period now open Drug and medical device manufacturers have completed their submission of data to the Open Payments system on payments or transfers of value made to physicians and teaching hospitals during 2015. Physicians and teaching hospitals now have 45 days to review and dispute records attributed to them. The review and dispute period is open from April 1 until May 15, 2016. The review and dispute process is voluntary, but encouraged. The Centers for Medicare and Medicaid Services (CMS) will publish the 2015 payment data and updates to the 2013 and 2014 ... April 4, 2016 General, Managed Care, Medi-Cal, Medicare CMS, Physician Payments Sunshine Act, Centers for Medicare and Medicaid Services 0 0 Comment Read More »
