The California Department of Health Care Services (DHCS) has extended by one month the time that beneficiaries of the Community-Based Adult Services (CBAS) program who actively declined to participate in a managed care plan may choose a managed care plan and still keep their CBAS services.
CBAS beneficiaries who already opted out of managed care now have until November 1, 2012, to select a managed care plan and keep their CBAS benefits. CBAS beneficiaries who did not opt out will begin receiving their CBAS benefits through a managed care plan on October 1.
According to DHCS, significant misinformation has been circulated about CBAS, formerly known as Adult Day Health Care (ADHC), including that eligible Medicare and Medi-Cal participants will lose access to their primary care physicians if they join a managed care plan. This has caused a large number of eligible beneficiaries to choose not to participate in CBAS.
Individuals who have both Medicare and Medi-Cal may in fact still use their Medicare doctors and pharmacies, DHCS says.
The new rules require that people with Medi-Cal who want to keep their CBAS benefits must be a member of a managed care health plan, like L.A. Care, as of November 1, 2012. Providers should encourage their eligible Medi-Cal members to join a managed care health plan to continue to receive their CBAS services.
Beneficiaries who opt out of managed care will continue to receive CBAS services through fee-for-service Medi-Cal until November 1, and then they will no longer be eligible to attend CBAS centers for nursing care, social services and meals.
For more CBAS information, including eligibility criteria, click here.
If you or your patients have any questions about enrollment in a health plan, please contact us at 1-888-839-9909.