50+ Participants Are Not Being Correctly Assigned to their Primary Care Provider

50+ Participants Are Not Being Correctly Assigned to their Primary Care Provider

By: Jorrel Sampana, MHLA

50+ Participants Are Not Being Correctly Assigned to their Primary Care Provider

50+ Participants Are Not Being Correctly Assigned to their Primary Care Provider 1024 683 My Health LA

My Health LA and other advocates for the 50+ transition to Medi-Cal are receiving reports from partners that beneficiaries are being assigned to the incorrect clinic based on their primary care provider or clinic selection in their Medi-Cal Managed Care Plan (MCP) enrollment via Health Care Options.  The California Department of Health Care Services (DHCS) is investigating potential causes, and providers and advocates urged DHCS to remedy the incorrect assignments as soon as possible to ensure continuity of care for patients.
DHCS has checked in with managed care partners and found that sometimes the partners do not have the most up to date Primary Care Plan selection available, often leading to the MCP defaulting patients to an undesired selection. DHCS has not provided further information as this point.

DHCS is collecting information on the issue. Examples can be sent via secure email to DHCS representative at Jillian.Davis@dhcs.ca.gov, CCALAC at LDorn@ccalac.org, or to a MHLA Program Advocate. Submitted information will allow us to determine the frequency, scale, and possible cause for this ongoing issue.