« The Dual Agenda: June 24, 2015 Issue

State Highlights


The California Department of Health Care Services (DHCS) released the latest enrollment numbers which show that 122,846 beneficiaries were enrolled in the Cal MediConnect dual demonstration project as of June 1. July and August pending enrollments are expected to add another 5,181 beneficiaries to the total. DHCS has also provided a breakdown of opt-outs by language, ethnicity and race. Information is provided for Los Angeles, Riverside, San Bernardino, San Diego, and Santa Clara counties.


MassHealth, the state’s Medicaid program, recently announced that Fallon Total Care, one of the three plans contracted in the One Care dual eligible demonstration project, will leave the project as of September 30, 2015. Fallon Total Care provides One Care coverage in Hampden, Hampshire, and Worcester counties to approximately 5,475 individuals.


The Michigan Department of Health and Human Services (MDHHS) hosted two regional forums, one in Detroit (Wayne County) and the other in Clinton Township (Macomb County), on the MI Health Link demonstration. Alison Hirschel and RoAnne Chaney, both leadership team members of the MI Voices for Better Health project, provided remarks on the work they are doing on the ground to reach consumers. These forums allowed attendees to share their early experiences with the demonstration.

New York

The Medicare Rights Center has prepared a toolkit for providers participating in the Fully Integrated Duals Advantage (FIDA) dual eligible demonstration project. The toolkit materials are intended to help providers understand FIDA’s goals, provider roles in the program, and how providers can help their patients make appropriate choices. The toolkit includes a presentation on helping patients understand FIDA; FAQs for providers; provider handouts; and links to additional resources.


A recent blog and action alert by UHCAN Ohio, lead organizer of the Ohio Consumer Voices for Integrated Care (OCVIC) coalition, urges consumers and advocates to contact their state legislator to approve the MyCare Ohio Independent Evaluation item in the state’s budget. The evaluation would examine consumer experiences with MyCare Ohio: their level of satisfaction, what choices they’ve made, how their lives have been impacted, whether they’ve experienced delays in getting needed services and whether their lives have been improved. Such an evaluation would allow advocates, consumers and the managed care plans both to target areas of improvement and build upon aspects that are working well for consumers.


The HMA Weekly Roundup reported last week on Virginia’s proposed plans for implementing statewide Medicaid managed long-term supports and services (MLTSS) and statewide managed care for dual eligible individuals. The state will transition approximately 107,000 users of Long-Term Services and Support (LTSS) and dual eligibles into managed care through a phased approach, with a targeted implementation of mid-2016 for the first phase and mid-2017 for the second phase. The first proposed phase of Virginia’s MLTSS implementation is the mandatory enrollment of dual eligibles who have opted out of the dual eligible financial alignment demonstration, called Commonwealth Coordinated Care (CCC), into a managed care plan for their Medicaid-only services. The second phase is split into two components. The first will include the dual eligible population that was excluded from the CCC: dually eligible persons under age 21, those in regions outside the CCC program area, and select individuals receiving Home and Community Based Service waiver services. The second component includes the non-dual (Medicaid-only) LTSS population.

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