Category

DUAL DEMONSTRATIONS

County-Specific D-SNP Fact Sheets for Advocates

By | DUAL DEMONSTRATIONS, DUAL ELIGIBLES, FACT SHEET, REPORTS

Dual Eligibles in a number of California counties who are currently enrolled in either Medicare Advantage Plans or certain Duals Special Needs Plans (D-SNPS) may see their plans change and/or may be subject to passive enrollment in Cal MediConnect, depending on a number of factors. The California Department of Health Care Services (DHCS) released the new Duals Special Needs Plan (D-SNP) policy last summer for beneficiaries in Los Angeles, Riverside, San Bernardino, San Diego, San Mateo, and Santa Clara Counties, and more recently for Orange County.

To help advocates unravel the complex policy and better advise their clients, Justice in Aging developed a series of county-specific fact sheets summarizing for advocates how beneficiaries are impacted depending on the type of Medicare Advantage plan in which a beneficiary is enrolled.

Today, we are releasing the Orange County fact sheet for the first time, and rereleasing the other county-specific fact sheets.

Orange County
Los Angeles County
Riverside County
San Bernardino County
San Diego County
San Mateo County
Santa Clara County

Please visit the Duals Demonstration Advocacy website for additional resources on the CCI.

Coordinated Care Initiative Fix List: Updated March 2015

By | DUAL DEMONSTRATIONS, DUAL ELIGIBLES, REPORTS

REPORT - FIX LIST

Justice in Aging continues to monitor the roll out of California’s Coordinated Care Initiative (CCI) through the CCI Fix List.  The Fix List tracks problems and related fixes and keeps advocates and others informed of the current state of CCI implementation in order to assist dual eligible beneficiaries who encounter problems during this important transition.

Justice in Aging has updated the Fix List to describe the most recent problems brought to our attention.  New issues identified since the prior publication of the CCI Fix List are bolded and marked with an asterisk.  Justice in Aging staff have discussed each problem with DHCS and CMS officials.  The list summarizes the remedial steps that both agencies report they have taken in response to each issue.

Senior Staff Attorney, Amber Cutler is testifying today before the Senate Budget Committee Hearing on CCI. The Fix List exists because the state moved too quickly into implementation, leading to confusion, poor consumer experience, and high opt-out rates. Our position is that for CCI to work as intended (improve care and save the state money) the state should focus more resources on improving care delivery, instead of on increasing enrollment. You can listen to the testimony here.

Beneficiaries who experience any of the Fix List problems or other CCI-related problems should contact the CCI Ombudsman for individual representation at (855) 501-3077 (TTY 1-855-847-7914).

Justice in Aging will continue to update the Fix List regularly and keep it posted here.

WEBINAR: The California Coordinated Care Initiative: Advanced Training Consumer Protections and Benefit Package Summary

By | DUAL DEMONSTRATIONS, WEBINAR
Free Webinar Series

When: Tuesday, October 21, 2014 10:00 – 11:00 AM PST

California is moving forward with the Coordinated Care Initiative (CCI), including the federally-approved dual eligible demonstration known as Cal MediConnect. The CCI started on April 1, 2014, in certain counties, and will continue to be implemented over the next year.

Read More

You’ve Got Mail: Designing Enrollment Notices for a Dual Eligible Demonstration Rollout

By | DUAL DEMONSTRATIONS

REPORT

With support from The Commonwealth Fund, NSCLC prepared a new resource, You’ve Got Mail: Designing Enrollment Notices for a Dual Eligible Demonstration Rollout. The resource is designed to assist consumer advocates and state officials preparing consumer notices and enrollment materials for the dual eligible demonstration.

Five states (Massachusetts, Ohio, Illinois, California and Virginia) have begun implementing a dual eligible demonstration and are sending notices eligible individuals to enroll in new Medicaid-Medicare Plans. Their experience to date in designing notices and coordinating the enrollment and consumer outreach process provides important information and insights for states and stakeholders preparing for implementation.

The resource provides an overview of the four key elements of the notice design process and includes a guide to the content states and the federal government require each notice and outreach document to include. Highlights of current practices in implementing states are included throughout the guide.

For more information, please contact Georgia Burke or Fay Gordon.