HCFA approves plan that brings public providers into single HMO for low-income residents of one Alabama county
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December 31, 1996
California launching State-Only Family Planning program
SACRAMENTO, CA—California is expanding access to family planning services for state residents with incomes below 200% of the federal poverty level under the new State-Only Family Planning (SOFP) program. Scheduled to begin in January, the program will offer a vast network of providers to both men and women who meet the income requirements. Ken August, spokesperson for the California Department of Health Services, says there are currently only 112 providers contracting with the program. They are paid a fixed amount for family planning services. If they exceed that amount, they must charge the patient. Now, providers in the network will bill for services at Medi-Cal rates.
Some 465,000 Californians use the program now, but that number is expected to increase by 200,000 in the next few years because of expanded access. SOFP was created through a partnership between Medi-Cal and the Office of Family Planning, Services are currently provided through a limited number of county health departments, universities and non-profit clinics. The SOFP will expand the network to include private physicians, HMOs, pharmacies and labs, as well as local health departments, community clinics and other traditional family planning providers. Those who want to participate in the network are required to attend one-day educational sessions that are being held around the state. Providers can determine and activate the patient’s eligibility, Mr. August said. SOFP will begin in a few counties in January, with enrollment in the rest of the state taking place during March and April.
Contact Department of Health Services at 916-657-3064.
BIRMINGHAM, AL—Alabama has just won approval from the Health Care Financing Administration (HCFA) for a Medicaid research demonstration project in Mobile County. The state will test a single-at-risk managed care plan that integrates a private health maintenance organization (HMO) with traditional public providers, including public hospitals and community health centers.
Under the waiver, Medicaid beneficiaries will be enrolled in the BAY Health Plan. They will choose their own primary care provider from the network, but may change providers at any time. All mandated Medicaid benefits will be provided without copayments, deductibles or cost-sharing. BAY Health Plan also will expand the eligibility
period from the current 60 days postpartum to up to 24 months.
HCFA worked with the state to develop assurances for beneficiaries who will be enrolled in the single plan.
HCFA approves plan that brings public providers into single HMO for low-income residents of one Alabama county
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