CalAIM Subacute Care Facility Long-Term Care Carve-In
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Return to CalAIM Long-Term Care Carve-In Transition Homepage
Under CalAIM, subacute care services transitioned to Medi-Cal managed care in order to standardize adult and pediatric subacute care coverage statewide. In addition, the Subacute Care Carve-In will advance a more consistent and integrated system of managed care and increase access to comprehensive care coordination, care management, and a broad array of services for Medi-Cal members in subacute care.
For more information on subacute care services, please visit the
Subacute Care webpage.
January 1, 2024 Transition
Effective January 1, 2024, all Medi-Cal managed care plans (MCPs) became responsible for covering institutional long-term care (LTC) services for adult and pediatric subacute care.
Adult subacute care services newly transitioned from Medi-Cal Fee-For-Service (FFS) to Medi-Cal managed care are within 31 counties:
Alameda, Alpine, Amador, Butte, Calaveras, Colusa, Contra Costa, El Dorado, Fresno, Glenn, Imperial, Inyo, Kern, Kings, Madera, Mariposa, Mono, Nevada, Placer, Plumas, Sacramento, San Benito, San Francisco, San Joaquin, Sierra, Stanislaus, Sutter, Tehama, Tulare, Tuolumne, and Yuba.
Pediatric subacute care services will be newly transitioning from Medi-Cal FFS to Medi-Cal managed care within 36 counties:
Alameda, Alpine, Amador, Butte, Calaveras, Colusa, Contra Costa, El Dorado, Fresno, Glenn, Imperial, Inyo, Kern, Kings, Los Angeles, Madera, Mariposa, Mono, Nevada, Placer, Plumas, Riverside, Sacramento, San Benito, San Bernardino, San Diego, San Francisco, San Joaquin, Santa Clara, Sierra, Stanislaus, Sutter, Tehama, Tulare, Tuolumne, and Yuba.
DHCS has developed policies and resources to support the subacute care transition from FFS Medi-Cal to Medi-Cal managed care. All resources can be found under “Key Documents" section. As new or updated resources are published, they will be highlighted in the “Important Updates" section.
Important Updates
All Plan Letter and Frequently Asked Questions – Updated September/October 2024
In September 2024, DHCS released 24-010: Subacute Care Facilities – LTC Benefit Standardization and Transition of Members to Managed Care, which supersedes APL 23-027. The revised APL clarifies requirements for authorization timelines, Share of Cost, and processes for implementing updated Medi-Cal FFS per diem rates. In October 2024, DHCS issued an updated Subacute Frequently Asked Questions (FAQs) document to further clarify updates made in the revised APL. The revised APL 24-010 and FAQs can be found under Key Documents.
LTC Learning Series
DHCS is hosting an LTC Learning Series during Fall 2024. The LTC Learning Series consists of a series of educational webinars for Medi-Cal MCPs and all LTC providers. The content presented in these webinars has been shaped by stakeholder feedback with the goal of enhancing MCPs', LTC providers', and interested stakeholders' understanding of Medi-Cal managed care and LTC. Each session covers different topics tailored to its intended audience. Details are included under Informational Webinars below.
Contracting with DHCS' Subacute Care Unit
MCPs must ensure that if a Medi-Cal member needs adult or pediatric subacute care services, they are placed in a health care facility that is under contract for subacute care with DHCS' Subacute Contracting Unit (SCU) or is actively in the process of applying for a contract with DHCS' SCU. A list of approved and active Subacute Care contracted facilities can be found on the DHCS SCU website. More information for facilities can be found on the Medi-Cal Subacute Care Contracting: Application Information for Facilities Fact Sheet under Key Documents.
Information for Members
DHCS developed member notices and other resources designed to ensure a seamless transition for Medi-Cal members in subacute care whose coverage transitioned to managed care. The Subacute Care LTC Enrollment notices and other resources for members are available on the
Subacute Care Carve-In Member Information webpage.
Key Documents
Informational Webinars
To support stakeholder planning and implementation, DHCS is hosting an educational webinar series. Details and materials for each webinar can be found below.
Upcoming Webinars
Past Webinars
LTC Learning Series: Managed Care Resources for LTC Providers: December 17, 2024 at 9:00 a.m.
Long-Term Care (LTC) Learning Series: LTC Policy Update: November 4, 2024 at 11:00 a.m.
LTC Learning Series Spotlight on Subacute Care: Monday, October 7, 2024 at 2:30 p.m.
Subacute Care Facility Carve-In Office Hours: Wednesday, February 14, 2024 at 2:30 p.m.
How Medi-Cal Managed Care Supports Subacute Care Facility and ICF/DD Home Residents: December 15, 2023 at 9:00 a.m.
Subacute Care Facilities 101 for Managed Care Plans: Wednesday, September 13, 2023 at 10:00 a.m.
Subacute Care Carve-In 101 for Subacute Care Facilities: Friday, September 15, 2023 at 9:30 a.m.
Subacute Care Facility Carve-In Billing & Payment: Wednesday, November 29, 2023 at 3:00 pm.
Additional Resources
Listed below are additional resources:
Questions and Comments
Contact DHCS with any questions or comments about the CalAIM Subacute Care Facility LTC Carve-In Transition at
LTCTransition@dhcs.ca.gov.
