DHCS All Plan Letter 13-013: Continuity of Care for New Enrollees Transitioned Into Managed Care After Requesting a Medical Exemption

Informs Medi-Cal Managed Care Plans (MCPs)operating in Geographic Managed Care or Two Plan counties (not County Organization Health Systems, like Partnership) that they must ensure continuity of care for Medi-Cal beneficiaries transitioning from Fee For Service. MCPs must provide beneficiaries with the completion of certain covered services that the beneficiary was receiving from a non-contracted provider for up to 12 months when the beneficiary has an acute condition, serious chronic condition, is pregnant, has a terminal illness, is a newborn, or has a planned surgery.  The letter directs plans that all Medical Exemption Requests are to be treated as requests for continuity of care.  The full letter is available here.