LIHP Service

One of the great success stories of California’s implementation of the Affordable Care Act is the early expansion of Medicaid through county-run Low Income Health Programs (LIHPs). Over 600,000 Californians are already getting new coverage–which is nearly half of the Medicaid expansion population in California–already above the 500,000 projected when we started.

So when President Obama highlights that Oregon and Kentucky have signed up over 10% of their uninsured population, California can do it one better: we have more than that not just enrolled, but covered.

And they are all slated to be shifted into full Medicaid on January 1, 2014, automatically. They don’t even have to re-apply, or anything, since they already went through an eligibility check when signing up for the LIHP.

But, of course, things always end up being a little more complicated. They don’t have to re-enroll, but they may have to pick which Medi-Cal managed care plan to be part of. Today, DHCS sent a notice informing of an issue, which they are working on correcting:

“DHCS has begun informing LIHP enrollees about the transition and providing them with information that will help during the next couple months.  In connection with this process, DHCS mailed a 60 day notice on November 1, 2013, and will mail a second notice on December 2, 2013, reminding enrollees of the transition to Medi-Cal.

“It has come to our attention that 246,023 of the 483,800 mailings to LIHP enrollees included an incorrect notice for the November 1, 2013, notice. The incorrect notice informed enrollees that their provider was not part of the Medi-Cal managed care network and they may need to pick a new provider.  These letters are only related to members assigned to a facility for their primary care and not specifically to an individual primary care provider.

“DHCS has identified the persons impacted.  To remediate the situation, DHCS will mail a retraction notice and a correct version of the 60 day notice letting LIHP enrollees know their provider does work with Medi-Cal and the plan(s) they work with. These new notices will mail between November 12 – 14, 2013.  DHCS is committed to ensuring a smooth transition to Medi-Cal for these members and will begin working with the counties and Medi-Cal health plans to ensure they are aware of which facilities are impacted. DHCS will also keep updated information on the LIHP transition website to ensure everyone can get information on the overall transition to Medi-Cal.

–          “This does not impact Alpine, Amador, Butte, Calaveras, Colusa, Del Norte, El Dorado, Glenn, Humboldt, Inyo, Kern, Lake, Lassen, Marin, Mariposa, Mendocino, Modoc, Mono, Monterey, Napa, Nevada, Orange, Placer, Plumas, San Benito, San Diego, San Joaquin, San Mateo, Santa Clara, Santa Cruz, Shasta, Sierra, Siskiyou, Solano, Sonoma, Sutter, Tehama, Trinity, Tuolumne, Ventura, Yolo, and Yuba counties.

–          “11 counties are impacted – Alameda, Contra Costa, Imperial, Kings, Los Angeles, Madera, Riverside, Sacramento, San Bernardino, San Francisco, and Tulare..

–          “Enrollment Choice Packets and forms were not a part of this mailing, members will begin receiving these mid to late November.. There was no plan assignment in the notice. Plan assignment will be part of the 30 day notice.

We hope this situation is remedied quickly, for these Californians who are the easiest to enroll, since they are already identified and determined eligible. More info is available at: at http://www.dhcs.ca.gov/provgovpart/Pages/LIHPTransitionResource.aspx

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