Health Care Waiver or Demonstration Project in California Medicaid – Cal. Welf & Inst. Code §14180

“Health care waiver or demonstration project; application; proposals; amendments”

The State Department of Health Services must implement a demonstration project as part of its Medicaid program that does the following:

• Strengthen the state’s safety net for low income individuals;
• Reduce the number of uninsured;
• Address uncompensated care;
• Improve health care quality and outcomes;
• Promote home and community based care.

The law requires the demonstration projects to restructure the existing delivery system to be more responsive to the needs of Medicaid beneficiaries, and better coordinate care.  Additionally, the demonstration projects must increase coordination between the Medicare and Medicaid programs in the state.  In order to enhance the quality of care, the law allows the Department to explore different delivery options, such as primary care management, medical homes, or managed care plans. 

The law also provides that any demonstration project application submitted must include processes, and accompanying criteria, upon which the department may evaluate and grant exemption, on an individual basis, from this section's requirements pertaining to the mandatory enrollment of beneficiaries in specified organized delivery systems.

Tags:

State government, Medicaid/CHIP data, Medicare data, Quality