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The California Department of Health Care Services (DHCS) is a department within the California Health and Human Services Agency that finances and administers a number of individual health care service delivery programs, including Medi-Cal, which provides health care services to low-income people.
The Department of Managed Health Care (DMHC) is a regulatory body governing managed health care plans, including Health Maintenance Organizations (HMOs) and most Medi-Cal managed care plans in California. The DMHC was created as the first state department in the country solely dedicated to regulating managed health care plans and assisting ...
The California Medical Assistance Program (Medi-Cal or MediCal) is the California implementation of the federal Medicaid program serving low-income individuals, including families, seniors, persons with disabilities, children in foster care, pregnant women, and childless adults with incomes below 138% of federal poverty level.
This means they also qualify for a Dual Eligible Special Needs Plan (D-SNP). SNPs provide tailored benefits, health provider lists, and prescription drug lists (formularies) to meet specific needs.
The California Health and Human Services Agency (CHHS) is the state agency tasked with administration and oversight of "state and federal programs for health care, social services, public assistance and rehabilitation" in the U.S. state of California.
As of 2015, about 14.1 million people were insured privately, including in self-funded plans; 1.3 million were in plans regulated by the CDI and 12.7 million were in plans regulated by the DHMC. [9] Kaiser Permanente had about 50% of the market, followed by Blue Shield of California, Anthem Blue Cross, and Health Net (a subsidiary of Centene). [9]
In addition, dual-eligibles may choose a type of MA plan called a dual-eligible special needs plan (D-SNP), which is designed to target the needs of this population. For Medicaid benefits, beneficiaries generally enroll in their state's Medicaid FFS program or a Medicaid managed care plan administered by an MCO under contract with the state.
Healthy Way L.A. provides a primary care provider team to members and expanded access to primary, preventative and specialty services, as well as access to hospital-based inpatient and outpatient services. [14] It is a county implementation of the state Low Income Health Program (LIHP). In the 2010-2011 fiscal year, DHS reported a budget ...