Long-Term Care Fee-for-Service Equivalent Directed Payment
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In accordance with State law (Welfare and Institutions Code, Section 14184.201(b) and (c)), the Department has directed Medi-Cal Managed Care Plans (MCPs) operating in Geographic Managed Care/Regional Model/Two-Plan Model non-Coordinated Care Initiative (CCI) “transitioning" counties to reimburse network providers of Long-Term Care (LTC) services, as defined at Welfare and Institutions Code Section 14184.201(g), as of the following dates: skilled nursing facility (SNF) services as of January 1, 2023, and other institutional LTC services as of January 1, 2024.
The goal of this delivery system reform arrangement is to support the carve-in of LTC services into the Medi-Cal managed care delivery system statewide while maintaining access to services and price stability and avoiding interruption of or disruption to critical care for the vulnerable institutionalized population.
For any managed care questions regarding this program, please reach out to Health Plan Directed Payment team at PlanDP@dhcs.ca.gov.
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