New Plan Offered to Dual Eligible Medicare-Medi-Cal Patients

                                                   By Sue U. Malone, Executive Director




Sue U. Malone

 

You may already have heard of the new program, called CareAdvantage, developed by the Health Plan of San Mateo (HPSM) that integrates Medicare Parts A and B, a Part D drug plan, and Medi-Cal benefits under a single health plan. If not, you may want a heads up.

HPSM, the Medi-Cal managed health care plan in this county, sought, and recently received, authorization from the Centers for Medicare and Medicaid (CMS) to implement a Medicare Advantage Special Needs Plan for their Medi-Medi members (known as dual-eligibles) who are enrolled in both the Medi-Cal and Medicare programs. There are approximately 10,000 dual-eligibles in the county. The HPSM CareAdvantage program is only authorized to provide these benefits to the Medi-Medi population.

At first we were concerned that the plan, set up as a “passive” or “opt-out” patient election, might disrupt continuity of care and potentially sever long-standing physician-patient relationships. However, having met with Mia Altman, the new interim executive director of the HPSM, and Wayne Pan, the medical director, as well as with the director of finance and the director of operations, we felt that the program may actually benefit physicians and patients.

CareAdvantage will have a separate network of doctors. To ensure continuity of care, the CareAdvantage program will contract with physicians for the CareAdvantage network without requiring physicians to participate in the  Medi-Cal program. All providers in the new network will be enrolled in the HPSM/CareAdvantage network. In addition, as an incentive to doctor participation in the new program, the HPSM will reimburse doctors at 90 percent of the Medicare allowable rate, rather than 80 percent as payment in full.

Under the plan, patients will be relieved of the burden of deciding what Part D Drug Plan (PDP) to select and will not be responsible for premiums or deductibles called for under the regular Part D program, though there will be a small $1 to $5 co-payment for each prescription.

I hope you will consider joining this network. HPSM will be sending a mailing to all Medi-Medi patients in October informing them of this new plan. This is a passive (opt-out) enrollment program. A patient can opt-out of CareAdvantage and choose the traditional Medicare (fee-for-service Medicare), or another Medicare Advantage managed care plan. If a patient selects the fee-for-service Medicare program, he/she will be required to select or be assigned a Part D drug plan. The CareAdvantage program goes into effect on January 1; however, patients must make their election by October 31. After that, Medi-Medi members will still be able to opt-out of CareAdvantage  and select another Medicare Advantage managed care plan or the traditional Medicare program on a monthly basis.   

We are informed that the HPSM will be working with its Medi-Medi members to identify their current physicians for Medicare services. The plan will then contact these physicians to encourage them to contract with the new Care Advantage program. There will be a six-month transition period (from January through June 2006) during which noncontract physicians will continue to be paid by the plan at current Medicare fee-for-service rates and will be asked to sign contracts. As mentioned earlier, members will be able to opt-out if they wish to stay with their provider and the physician does not elect to join the HPSM CareAdvantage network.

You may be aware that in recent years HPSM has been faced with severe financial challenges. The other programs that HPSM administers have helped them offset these challenges posed by lack of adequate funding in the Medi-Cal managed care program. This new program also will help offset these continuing deficits in the Medi-Cal program.

Based on the complexity of the new Part D drug program, we feel that the CareAdvantage program will work well for Medi-Medi patients and will aid physicians in retaining their Medi-Medi patients.

Call HPSM to sign up for the CareAdvtange network or ask questions about the program. The HPSM Provider Relations Department can be reached at 650-616-2106.