December 9, 2009

State of California's Concept for a Comprehensive Section 1115 Waiver to Replace the Current Medi-Cal Hospital/Uninsured Care Demonstration Project

The California Department of Health Care Services (DHCS) is seeking to renew its Medicaid 1115 waiver to transform the Medi-Cal program to create an accountable, efficient, coordinated system of care. The revision, authorized by Assembly Billx4 6 (ABx4 6) is intended to strengthen the health care safety net, reward health care quality, improve health outcomes, slow the program's long-term cost growth rate, and expand coverage to uninsured state residents. Its current 1115 waiver expires August 31, 2010; the revised waiver will start September 1, 2010. A key concern for the state is integrating Medicaid and Medicare services for people who are dually eligible for both programs. This population is currently in fragmented and uncoordinated care which typically results in high care costs.