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Archives
- December 18, 2019
Advocate Fact Sheet: Evaluating Mental Health Plans’ Provision of Medi-Cal Specialty Mental Health Services
Read moreMedi-Cal beneficiaries in California receive mental health services through two separate managed care systems. Medi-Cal Managed Care Plans (MCPs) are responsible for providing non-specialty mental health services and County Mental Health Plans (MHPs) are responsible for providing specialty mental health services (SMHS). This bifurcated system often serves as a…
- October 21, 2019
Internal and External Review: Medi-Cal Managed Care Plans Managed Care in California Series Issue No. 4 (Revised October, 2019)
Read moreFederal and state law and the state and federal Constitutions require that enrollees in Medi-Cal managed care plans receive notice, and grievance and appeal rights when they are denied access to medically necessary services. Frequently, however, enrollees fail to receive the required notice, get an inadequate notice, or do not…
- April 8, 2019
National Health Law Program Comments on HHS Safe Harbor Rule for Outpatient Prescription Drugs
Read moreThe U.S. Department of Health and Human Services (HHS) proposed new regulations that would remove safe harbor protections for prescription drug rebates. Currently, rebates paid by manufacturers to Medicare Part D plans and Medicaid managed care organizations (MCOs), including pharmacy benefit managers (PBMs) are shielded from federal anti-kickback laws.…
- March 15, 2019
Advocate Fact Sheet: Monitoring Plan’s Provision of Mental Health services to Medi-Cal Beneficiaries
Read moreCalifornia has two managed care plans that are responsible for providing mental health care to beneficiaries of Med-Cal, the state's Medicaid program. Senior Attorney Abigail Coursolle, in this fact sheet, provides guidance and tools for California health care advocates to monitor and ensure that the state's managed care plans…
- January 16, 2019
National Health Law Program Comments Regarding Proposed Rule Changes on Medicaid Managed Care and CHIP
Read moreThe National Health Law Program in comments to the U.S. Department of Health and Human Services urges it to reject several proposed changes to Medicaid Managed Care and the Children's Health Insurance Program (CHIP) that would weaken oversight of managed care setups, undermine current standards ensuring access to care…
- November 2, 2018
Navigating The Challenges of Medi-Cal’s Mental Health Services in California: An Examination of Care Coordination, Referrals and Dispute Resolution
Kimberly Lewis, Abigail Coursolle, Héctor Hernández-Delgado, Hayley Penan, and Alexis Robles-Fradet Manual/ReportRead moreMedi-Cal plays a crucial role in providing mental health services in California. In 2015, over 600,000 Californians – approximately two percent of the State’s population – received mental health services paid for by Medi-Cal. While Medi-Cal plays an important role in delivering necessary mental health services to Californians, many…