August 02, 2018
Health Care Alert
Health Care Alert
This alert discusses how the July 1, 2018, Medi-Cal expansion by eight California counties will impact providers of substance abuse services.
Eight counties in California, including Orange County and San Diego County, launched a program funded by Medi-Cal to combat substance abuse on July 1, 2018. These eight counties represent approximately 25% of the state’s nearly 40 million residents. Prior to this, since the beginning of 2017 when the program was originally launched, another 11 counties, including Los Angeles, San Francisco, Contra Costa and Riverside had already implemented the program. Altogether, these 19 counties represent nearly 75% of the Medi-Cal population statewide.
The program is referred to as the Drug Medi-Cal Organized Delivery System (“DMC-ODS”) Pilot and it seeks to restructure Substance Use Disorder (“SUD”) services in participating counties into an organized delivery system that:
Services provided under the DMC-ODS Pilot include:
Under the program, counties receive an increase of about $125 million in federal Medicaid funds per county over the next three years. However, during the pilot program, counties must first develop a Quality Improvement Plan that ensures the county is monitoring service deliveries and is keeping track of the geographic distributions of substance use disorder services. Additionally, counties must complete requirements such as establishing a toll free 24/7 call line for individuals to access DMC-ODS services in order to prove accessibility. Data from the program will then be reviewed on a quarterly basis by University of California, Los Angeles’ Integrated Substance Abuse Program and the county’s own Quality Improvement Committee for evaluation. While it may still be early to draw conclusions based on the existing data, if the DMC-ODS Pilot is successful between now and 2020, the program may become permanent.
The foregoing has been prepared for the general information of clients and friends of the firm. It is not meant to provide legal advice with respect to any specific matter and should not be acted upon without professional counsel. If you have any questions or require any further information regarding these or other related matters, please contact your regular Nixon Peabody LLP representative. This material may be considered advertising under certain rules of professional conduct.
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