New Medi-Cal Care System Is Delayed Another Month

Because of delays caused by the county bankruptcy and state rate setters, the agency organizing Orange County’s new managed care system for Medi-Cal recipients decided Tuesday to postpone its start-up by another month.

The postponement means CalOPTIMA will begin operations on Oct. 1, two months behind schedule. The agency’s board already had agreed in April to delay start-up by at least one month. At that time, it left open the possibility of pushing back the date still further if finances allowed.

The postponement was needed in part because the state Department of Health Services, which sets payment rates for Medi-Cal providers, released its proposed rates four months later than expected, agency officials said.

Potential CalOPTIMA contractors have complained for months that it is impossible for them to complete plans to participate in the system serving about 300,000 Medi-Cal recipients without knowing what payment to expect.

CalOPTIMA also was set back by the county’s plunge into bankruptcy on Dec. 6.

About $2.4 million in start-up costs for CalOPTIMA were caught up in the bankruptcy, causing the organization to impose a two-month hiring freeze just as it was getting on its feet.

Each month that start-up is delayed costs the agency about $400,000, said CalOPTIMA spokeswoman Kathi Crowley. But the agency will receive about $450,000 as part of the bankruptcy settlement approved earlier this month.