Biweekly Briefing Articles

5 Things To Know: Medi-Cal Redeterminations, Covid-19 Precautions, National Recovery Month, Timely Claims Payments, HCAI Seismic Webinars

MEDI-CAL REDETERMINATIONS: The Department of Health Care Services has published a new interactive dashboard detailing statewide and county-level demographic data on Medi-Cal application processing, enrollments, redeterminations, and renewal outcomes. Preliminary data on the Medi-Cal redeterminations show that in San Diego County, 16,336 Medi-Cal beneficiaries were disenrolled effective June 30. In Imperial County, 1,482 beneficiaries were disenrolled and across the state, a total of 225,231 Medi-Cal beneficiaries were disenrolled effective June 30. While these are very preliminary counts for June’s disenrollment figures, it is important to note that the final numbers could increase if more individuals do not submit paperwork or are found to be no longer eligible.

San Diego County

Imperial County

COVID-19 PRECAUTIONS: San Diego County Emergency Medical Services (EMS) is urging EMS professionals to take continued protective measures against COVID-19. In a recent memo, Medical Director Kristi Koenig, MD, writes that San Diego County epidemiologic surveillance indicates we are entering a late summer COVID-19 surge. She notes the impact that infections can have on staffing in both prehospital and hospital settings and encourages EMS professionals to be up to date on influenza and COVID-19 vaccinations. She also recommends masking patients for source control, as appropriate.

NATIONAL RECOVERY MONTH: San Diego County Behavioral Services is kicking off recovery month, which is recognized every September, by holding a free celebration on Aug. 26 at Waterfront Park to raise awareness, reduce stigma, and shine a light on recovery. In addition to valuable resources, the event will be filled with fun interactive activities, music, and shared stories of hope from those with lived experience. Free naloxone and event giveaways will also be available for attendees while supplies last. This year’s National Recovery Month Celebration event theme is “Celebrate the Tides of Hope,” focusing on the resiliency of individuals in recovery. Email with any questions about the event.   

TIMELY CLAIMS PAYMENTS: The Department of Health Care Services (DHCS) has released an All-Plan Letter reminding Medi-Cal managed care plans of their responsibility to pay providers on a timely basis. It follows March guidance from the Department of Managed Health Care that was prompted by CHA advocacy, and demonstrates continued engagement and concern from state regulators that plans are not meeting their basic responsibility of promptly paying for the care their members receive. The DHCS guidance clarifies the various obligations of Medi-Cal plans under state and federal law, which include:

  • Plans and their subcontractors must pay any uncontested claim within 30 working days of claim submission. 
  • A provider is entitled to interest when an uncontested claim is not paid within 30 working days.    
  • Plans have sufficient dispute resolution processes in place for contracted and non-contracted providers, including with respect to timely claims processing.  

HCAI SEISMIC WEBINARS: On Aug. 31, the Department of Health Care Access and Information (HCAI) will hold a webinar on Assembly Bill 1882 requirements to review the requirements of Policy Intent Notice 75. HCAI will also hold a webinar on Aug. 22 on the water storage required by Nonstructural Performance Category-5, as a part of the 2030 seismic building standards. More details are available in this CHA News article.