Policy Issues

Overview

LHPC Policy Issues

LHPC supports member plans’ mission of providing access to health care for California’s most vulnerable populations by:

  • Promoting policies that expand access and affordability of health care;
  • Supporting cost-effective managed care strategies; and
  • Educating policy makers and the public about the unique and vital contributions of California’s local health plans.

We work closely with the statewide agencies that regulate local health plans – Department of Health Care Services (DHCS) and Department of Managed Health Care (DMHC) – and with Covered California, the California State Legislature and providers across the state.

Overview

Key Terms

Medi-Cal Fee-for-Service

Under fee-for-service Medi-Cal, beneficiaries are responsible for finding primary care providers and specialists who are willing to accept Medi-Cal; beneficiaries are not matched with a primary care provider who coordinates their care. The California Department of Health Care Services (DHCS) establishes fee schedules, negotiates rates with hospitals, determines medical necessity criteria and pays provider claims for services provided.

Commands