Medi-C​al 2020 Demonstration

Return to Section 1115 Medicaid Waiver Resources Webpage

California’s Section 1115(a) Medicaid Waiver, entitled Medi-Cal 2020, was approved by the Centers for Medicare & Medicaid Services (CMS) on December 30, 2015, and is effective through December 31, 2020. The Medi-Cal 2020 Demonstration aims to transform and improve the quality of care, access, and efficiency of health care services for over 13 million Medi-Cal members.

Following the end of the waiver period, DHCS intended to implement California Advancing and Innovating Medi-Cal (CalAIM), a multi-year initiative to initiate overarching policy changes across all Medi-Cal delivery systems. As part of CalAIM, DHCS intended to transition all existing managed care authorities into one consolidated 1915(b) California managed care waiver, and propose an 1115 waiver with other program authorities.  In 2019 and early 2020 DHCS conducted extensive stakeholder engagement for both CalAIM and the 1115 and 1915(b) waiver renewals.  While the goals and objectives of CalAIM continue to be a high priority, DHCS announced the delay of CalAIM in May 2020, due to the impact of COVID-19. For more information about the CalAIM initiative and stakeholder engagement process, please visit the CalAIM webpage.

DHCS received approval from CMS for a 12-month waiver extension on December 29, 2020.

General Waiver Resources

Stakeholder Engagement

DHCS values your input. Please email questions, comments, or concerns to: 1115Waiver@dhcs.ca.gov.
 
The Stakeholder Advisory Committee (SAC) and the Behavioral Health Stakeholder Advisory Committee (BH-SAC) are broad-based advisory committees intended to disseminate information and receive coordinated input regarding DHCS' work to provide high-quality physical health and behavioral health care.
 

Subscribe if you wish to be added to the DHCS stakeholder email service.

 

PRIME

The Public Hospital Redesign and Incentives in Medi-Cal (PRIME) Pool builds upon the Bridge to Reform Waiver’s Delivery System Reform Incentive Payments (DSRIP) program to improve the quality and value of care provided by California’s safety net hospitals and hospital systems.

Program Inbox: PRIME@dhcs.ca.gov  ​

​Global Payment Program

The Global Payment Program (GPP) streamlines funding sources for care for California’s remaining uninsured population and creates a value-based mechanism to increase incentives to provide primary and preventive care services and other high-value services.

Dental Transformation Initiative

The Dental Transformation Initiative (DTI) provides direct incentives to providers through program domains that promote overall children’s utilization of preventive services and oral health disease management, expand prevention and risk assessment models, and increase dental continuity of care.

Program Inbox: DTI@dhcs.ca.gov

DTI Mailing List: Subscribe

Whole Person Care

The Whole Person Care (WPC) regional pilots focus on the coordination of health, behavioral health, and social services, as applicable, in a patient-centered manner with the goals of improved beneficiary health and well-being through more efficient and effective use of resources.

Program Inbox: 1115WholePersonCare@dhcs.ca.gov

DMC-ODS

The Drug Medi-Cal Organized Delivery System (DMC-ODS) will demonstrate how organized substance use disorder care increases the success of DMC beneficiaries while decreasing other system health care costs. Critical elements of the DMC-ODS Pilot include providing a continuum of care modeled after the American Society of Addiction Medicine (ASAM) Criteria for substance use disorder treatment services.

Program Inbox: DMCODSWaiver@dhcs.ca.gov

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Additional Waiver Programs

 

Last modified date: 12/31/2020 10:02 AM