SB 492: Coordinated Care Initiative: consumer educational and informational guide.

Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid Program provisions. One of the methods by which these services are provided is pursuant to contracts with various types of managed care health plans. Existing federal law provides for the federal Medicare Program, which is a public health insurance program for persons 65 years of age and older and specified persons with disabilities who are under 65 years of age.

Existing law, the Coordinated Care Initiative (CCI), requires the department to seek federal approval pursuant to a Medicare or a Medicaid demonstration project or waiver, or a combination thereof, to establish a demonstration project that enables beneficiaries dually eligible for the Medi-Cal program and the Medicare Program to receive a continuum of services that maximizes access to, and coordination of, benefits between the programs.

This bill would make legislative findings and declarations relating to the CCI and the availability of consumer protections for beneficiaries. The bill would require, no later than July 1, 2016, the department to develop and post on the department’s Internet Web site, an educational and informational guide to assist consumers and patients in understanding the rights afforded to them under the CCI and how to effectively exercise those rights, as specified. The bill would require the department to distribute the educational and informational guide to specified consumer advocacy groups and programs and, upon request, to all other interested persons. The bill would require the department to update the educational and informational guide annually, or as necessary, to keep the information contained in the guide up to date regarding changes to the CCI.