Medical Case Management Program

What is the Medical Case Management Program?

The Medical Case Management (MCM) program under the oversight of the newly established Systems of Care
Division within the Department of Health Care Services (DHCS), provides short-term case management for full scope Medi-Cal recipients which require medically intensive services. Recipients may be eligible for this program if they have no other health coverage other than Medi-Cal. They may have a share of cost.

Program Overview

The MCM program is voluntary for providers and Medi-Cal recipients. Key points of the program are as follows:

• Case managers are registered nurses that coordinate and authorize outpatient services which may expedite a recipient’s hospital discharge to a private residence or to maintain them in a home-care setting. Case managers provide no hands on care.
• Case managers work directly with hospitals, home health agencies, physicians and other Medi-Cal providers to ensure the appropriate and expedited authorization of medically necessary services.
• Case management goals are to ensure safe hospital discharges, continuity of medical care in the home-care setting, and to stabilize recipients with complex, chronic and/or catastrophic medical conditions.

How to make a referral or obtain additional information?


Hospitals, home health agencies, physicians or other Medi-Cal providers may refer a recipient to the MCM program by calling a field office listed in our directory or by calling MCM Headquarters at: (800) 970-8450 or via e-mail at: MCMHQ@dhcs.ca.gov.


For any questions regarding Medi-Cal eligibility, please contact the MCM Eligibility coordinator at: (800) 970 8450.


Para información adicional del programa MCM en Español por favor llame al (800) 970-8450.