April 26, 2023
1:30 – 3:00 p.m., Pacific Time

Registration is now closed.

Overview

Who does the Medi-Cal program cover?
How does one become eligible for Medi-Cal?
How does an individual get enrolled in a Medi-Cal managed care plan?

The Medi-Cal program is critically important to more than 15 million Californians — most of whom receive their health services through managed care. But despite its broad reach, not everyone is eligible for Medi-Cal. Because the program is jointly funded and administered by the federal and state governments, specific eligibility requirements must be met and verified before individuals can access and receive care. Such eligibility information, which is procured through the application and verification processes, provides health plans with vital information about the characteristics and needs of the members they serve.

Join us for this introductory webinar and learn more about Medi-Cal eligibility and enrollment, including who’s eligible, the different pathways to eligibility and enrollment, how the enrollment process works, and how individuals are assigned to and enrolled in a managed care plan.

Who should attend:
Local health plan staff from all departments and at all levels who have an interest in understanding the basics of eligibility and enrollment or perform functions that are connected to or impacted by Medi-Cal eligibility and enrollment activities.

Agenda

Medi-Cal Eligibility — Context & Overview

• Joint federal and state-governed program with prescribed guidelines and requirements
• How federal requirements affect Medi-Cal eligibility
• Factors that drive eligibility

Who’s Eligible for Medi-Cal Coverage?

• Covered populations
• Modified Adjusted Gross Income (MAGI) and its impact on eligibility
• MAGI vs. non-MAGI populations — why this distinction is important

Pathways to Eligibility & Enrollment

• “All paths lead to coverage” approach to enrollment
• What happens once an application is filed
• Redetermination process for maintaining coverage

Enrolling in a Managed Care Plan

• How individuals enroll in a managed care plan
• How different plan models impact enrollment processes
• Issues around enrollment — changing health plans,
  auto-assignments

How Plans Use Eligibility Information

• How eligibility information is used by health plans — PCP assignments, informing providers, etc.

Current Issues in Managed Care Enrollment

• Restart of Medi-Cal redeterminations
• Medi-Cal churn
• Existing and new expansions for undocumented adults
• Outreach to the uninsured
• Managed care enrollment of majority of Medi-Cal beneficiaries

Faculty

Karli Holkko
Senior Self-Sufficiency Policy Analyst
County Welfare Directors Association

Karli Holkko joined CWDA in March 2023 as a Senior Self Sufficiency Policy Analyst. In this role she has lead responsibility for analytical and program support activities in the areas of health care and nutrition.

Throughout her career, Karli has been a passionate advocate for access to care for underserved populations. Prior to joining CWDA Karli served as Government Affairs Director for WelbeHealth, a Program of All-inclusive Care for the Elderly (PACE). Karli also worked for Sutter Health’s PACE program and the California PACE Association. Karli started her career at the Department of Health Care Services where she gained programmatic experience in Medi-Cal, PACE, Managed Care, and home and community-based services. 

Karli earned a Bachelor of Science in Kinesiology and a Master of Arts in Gerontology from California State University, Sacramento.

Thomas Pham
Vice President of Strategy
Inland Empire Health Plan

Thomas Pham understands what it means to grow up in a challenging environment. He also knows the incredible impact that comes when individuals and families see hope on the horizon. Thomas has made it his life’s work to help every resident of the Inland Empire find their path to a healthy and joyful life. His greatest passion is helping those who face the greatest obstacles or are furthest from equity. 

As the Vice President of Strategy, Thomas develops and executes IEHP’s Strategy System to advance the organization’s Mission and achieve their bold 2030 Vision. He leads the creation and implementation of IEHP’s multi-year strategic plan and ensures the health of the entire strategy portfolio. He is responsible for the research of internal and external insights that help accelerate the organization’s success and help establish new strategic business opportunities. He is constantly seeking new ways to expand IEHP’s ability to serve the Inland Empire communities.   

Thomas received a Master’s in Public Health with an emphasis in Healthcare Administration from Loma Linda University and bachelor’s degree from University of California, Los Angeles.

Registration

This is an LHPC members-only program.

Fees* (per connection)
Members                            $30     
Plan Registration^            $130
*Special registration pricing will be offered while health plan staff work remotely. Standard pricing will resume once staff return to work
on-site.
^ Select this option if plan staff will view the webinars communally on-site. Plans with multiple sites must register each site separately and identify whom at each site should receive the webinar access information upon registering. When registering, please enter unique email addresses for each additional site as the system may not allow duplicate logins.

Registration closed April 21 at 5:00 p.m.

Registration Confirmation: Registrants will receive two emails — a registration confirmation email and a separate email that contains access information for the webinar. 

Participating in the Webinar: You will only need a computer with an updated web browser (Google Chrome, Microsoft Edge, Mozilla Firefox or Safari are recommended). Participants may opt to listen to the webinar via telephone or device. 

Cancellation Policy: Cancellation notification must be submitted in writing to institute@lhpc.org seven or more days prior to the course date. Refunds will not be given after that date. Substitutions are encouraged. Payment will be due for registered individuals that do not attend or participate in the event, and for which a cancellation notice is not received.