2024 DHCS Medi-Cal Transition – Counties Health Net will continue to serve

23-158e

Counties

• Fresno
• Kings
• Los Angeles
• Madera
• Sacramento
• San Joaquin
• Stanislaus
• Tulare

2024 DHCS Medi-Cal Contract Award Q&As

1. What happened to the RFP?
   DHCS has formally canceled the RFP and is using its authority to issue direct contracts on a county-by-county basis.
2. How long is the new contract?
   The contract will be five years, through December 31, 2028, auto-renewing at the end of each year for the next year.
3. What counties will Health Net no longer serve as of January 1, 2024?
   Health Net proudly serves individuals and families across California through our Medicare, Medi-Cal and Commercial lines of business. While the DHCS announcement means Health Net will no longer serve Medi-Cal members in counties in the rural north part of the state that will be converting to new Managed Care models in 2024, or Kern and San Diego counties, there are no impacts to our Medicare or Commercial lines of business in those areas. We remain steadfast in our commitment to partner with incoming Medi-Cal health plans to facilitate successful transitions. More information on transition plans will be provided soon.
4. What happens if the replacement plan in my county doesn't meet operational readiness requirements by January 1, 2024?
   Operational readiness is required effective January 1, 2024. DHCS reserves the right to extend contracts with existing plans should new plans require additional time to meet required readiness requirements.
5. What is the status of Imperial County?
   Effective January 1, 2024, Health Net will serve members in Imperial County as a subcontractor to Community Health Plan of Imperial Valley (CHPIV), similar to the CalViva relationship. Health Net will serve the entire county under this arrangement. No other health plan will serve this county. Health Net will provide all services and administration through its network and operations, and CHPIV will maintain an oversight role, much like CalViva. This county will transition to a single plan model in 2024.
6. What is the status of the CalViva contract?
   Health Net continues to serve Medi-Cal members in Fresno, Kings, and Madera counties as a subcontractor to CalViva. Anthem continues to be the Commercial plan.
7. Will the DHCS provide additional funding to subsidize cost increases for the health plans, and will this funding be passed down to the IPAs to maintain cost neutrality?
   DHCS is required to set actuarily sound rates. Program and benefit changes are considered in the process. Rates are evaluated annually. Provider must engage in negotiations with their respective health plans as part of their normal negotiation cycles.
8. Who do I submit questions to or contact if I need additional information?
   If you have additional questions or need additional information you can reach out to your Regional Network Director in Provider Network Management.