02/19/2013

Healthy Families program transition set to continue March 1


The state of California began the transition of its Healthy Families Program (HFP) to the Medi-Cal program on January 1. This first phase of the transition, which moved nearly 200,000 children, came on the heels of approval from the federal Centers for Medicare and Medicaid Services (CMS) late last year. CMS, however, only gave the state approval for the first phase of the transition and is requiring the state to again seek approval before they initiate the second phase (Phase 1b), set to begin on March 1.

If the state gets the approval, Phase 1b of the transition will begin, which includes approximately 95,000 children in the following counties:

  • Contra Costa
  • Fresno
  • Kern
  • Los Angeles
  • Madera
  • Tulare
  • Sacramento
  • Napa
  • Solano
  • Sonoma
  • Yolo
  • Monterey
  • Santa Cruz
  • Santa Barbara
  • San Luis Obispo

It is important to note that the children currently being served through HealthNet in Los Angeles, Kern, and Madera counties will not be included in Phase 1b and will not transition on March 1. They will be transitioned in Phase 1c, set to begin April 1, pending federal approval.

Once these beneficiaries transition into the Medi-Cal program, dentists will need to bill Denti-Cal for dental services provided. Dentists who are not enrolled in Denti-Cal, but would like to see their current patients when they transition into that service delivery system, can visit the Denti-Cal website at denti-cal.ca.gov for the Enrollment Application Guide.

Dentists who currently serve HFP patients who have not transitioned yet, or who are unsure if they have transitioned, can check eligibility through their normal HFP processes. If the patient is no longer eligible with HFP, dentists can check their Medi-Cal eligibility by calling 800.456.2387.

Denti-Cal has posted several new Denti-Cal Bulletins providing detailed information on the Healthy Families Transition, which can be accessed at denti-cal.ca.gov.

CDA has been actively participating and representing its members in all of the administration’s implementation meetings with stakeholder organizations, and has held many separate meetings with the department, legislative leaders and staff and advocates over the last few months regarding the Healthy Families Program transition. Those efforts will continue.

CDA will keep members informed as this issue progresses. For more information, contact Nicette Short at CDA at nicette.short@cda.org or 916.554.4970.