To: Board of Supervisors
From: Dr. Grant Colfax, Health Services Director
Report Title: Approval of Contract Amendments to Multiple Contra Costa Health Plan Contracts
?Recommendation of the County Administrator ? Recommendation of Board Committee
RECOMMENDATIONS:
APPROVE and AUTHORIZE the Health Services Director, or designee, to execute on behalf of the County contract amendments with 179 Contra Costa Health Plan (CCHP) providers specified on the attached list, effective January 1, 2026, to allow CCHP to meet the regulatory mandate of Department of Health Care Services ("DHCS") to implement a Dual Eligible Special Needs Plans (D-SNPs) and whereby allowing CCHP to meet the mandatory provider network adequacy standards of DHCS and the Center for Medicare and Medicaid Services ("CMS") and authorize existing contractors to provide specialized care to beneficiaries who are dually eligible for Medicare and Medi-Cal and offer care coordination and wrap-around services with no change in the original payment limits or terms.
FISCAL IMPACT:
Approval of these Contract Amendments will have no additional fiscal impact.
BACKGROUND:
In January 2022, the California Department of Health Care Services (DHCS) implemented its California Advancing and Innovating Medi-Cal (CalAIM) initiative, part of which requires that all Medi-Cal Managed Care Plans, like CCHP, have a D-SNP line of business as of January 1, 2026, unless determined otherwise by the DHCS exemption process.
D-SNPs are Medicare Advantage (MA) plans that provide specialized care to beneficiaries dually eligible for Medicare and Medi-Cal and offer care coordination and wrap-around services.
To comply with the DHCS mandate to implement a D-SNP line of business by January 1, 2026, CCHP is required to achieve network adequacy of its provider network. This means that CCHP must satisfy certain regulatory requirements to implement the DSNP line of business such as development of a DSNP provider networks that meets the...
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