Lawsuit Slams the State's Duals Project


Stakeholders last week filed a lawsuit in Superior Court lambasting Cal MediConnect, the dual eligibles demonstration project that is part of the state's Coordinated Care Initiative.

That process is misleading and confusing, according to the lawsuit filed July 2 in state Superior Court in Sacramento by the Los Angeles County Medical Association, three independent living centers in the county and an ophthalmologist based in Chula Vista. They said the frail, elderly and often cognitively impaired patients in the duals project have been harmed by inadequate readiness of implementation by the state, which the lawsuit said was confirmed by CMS review.

"This program has caused vast confusion among these patients," the lawsuit said. "At the same time, regulators have discovered various plans approved to participate in the program have had inadequate networks, or received low quality scores or failed to meet solvency requirements. Yet [state officials] have insisted on implementing the CCI -- even in the absence of statutory authority to do so."

David Gorn, California Healthline, 7/7/2014

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