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Healthy Families Program (HFP) Transition To Medi-Cal

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Pursuant to Assembly Bill (AB) 1494, (Committee on Budget, Chapter 28, Statutes of 2012), all Healthy Families Program (HFP) enrollees will transition to Medi-Cal as targeted low-income Medicaid children, as allowed under federal law, beginning January 1, 2013. The transition of approximately 875,000 HFP enrollees will be implemented in four separate phases over the course of one year and in a manner that minimizes disruption in services, maintains adequate provider networks, and ensures access to care. Each Phase will require an implementation plan, including information on health and dental plan network adequacy, continuity of care, eligibility and enrollment requirements, consumer protections, and family notifications.

The transition of HFP enrollees to Medi-Cal will simplify eligibility and coverage for children and families while providing additional benefits and lowering costs for children at certain income levels. The State will also gain administrative efficiencies, achieve General Fund savings, and provide a more consistent health plan contracting process while increasing plan accountability for providing high quality services to children.

The California Health and Human Services Agency, in collaboration with the Department of Health Care Services, the Managed Risk Medical Insurance Board and the Department of Managed Health Care will collaborate with the Legislature and stakeholder partners over the coming months to ensure a successful plan is created to transition the children from HFP to Medi-Cal. A transition plan will be provided to the Legislature no later than October 1, 2012. The Administration will convene a stakeholder process for preparation and transition and will have ongoing meetings throughout the transition.

Inquiries regarding the HFP transition efforts may be directed to: medi-calforfamilies@dhcs.ca.gov

Last modified on: 2/21/2014 3:57 PM