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July 1, 2014
Coverage of Pregnant Women in California
dfitzgerald Issue Brief
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June 27, 2014
Lessons from CA: Pregnant Women’s Coverage Options
dfitzgerald Issue Brief
The ACA made many positive changes in health coverage for pregnant women. Many women now qualify for both pregnancy-related Medicaid and financial assistance in the Marketplace. In this month's, Lessons from California, we highlight how NHeLP worked with California advocates to provide comprehensive Medi-Cal coverage for pregnant women, including…
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May 30, 2014
Lessons from CA: Delaying 2014 Renewals for Medi-Cal Enrollees
dfitzgerald Issue Brief
In June, current enrollees of California's Medicaid program, Medi-Cal, will be asked to complete a new renewal process and be evaluated under the new MAGI eligibility rules. But with nearly one million Medi-Cal applications still pending and a faulty IT system unable to accurately determine Medi-Cal eligibility, hundreds of…
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May 8, 2014
Network Adequacy Laws in Medi-Cal Managed Care Plans
Abigail Coursolle Manual/Report
Medi-Cal managed care plans are capitated, meaning they receive a set payment per enrollee per month in exchange for providing services.The plans contract on a "comprehensive risk" basis, which means they accept the risk of incurring a loss if they spend more on services than they receives through the…
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April 29, 2014
Re: California’s Bridge to Reform Demonstration (No. 11-W-00193/9)
dfitzgerald Comments
There are three major components of the CCI. As drafted, the amendment repeatedly fails to effectively delineate what changes are occurring under each of these separate components. The amendment frequently conflates the three components of the CCI, muddling an already complicated set of changes. The amendment should set forth,…
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April 29, 2014
Comments on All Plan Letter: Continuity of Care: Definition and Practice
dfitzgerald Comments
With the transition of seniors and persons with disabilities (SPDs) into managed care in 2011, we learned that COC is arguably the most critical factor in successfully transitioning high need beneficiaries into a new health care setting. The poor performance of COC protections led to significant, and at times…
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