CalOptima Takes Mental Health Administration In-House

Source: Thy Vo, Voice of OC, September 11, 2017

CalOptima, the county’s health care plan for low-income and elderly residents, now will administer its own mental health care services, after the agency voted to phase out its $41 million-a-year contract with Magellan Health. The agency’s Board of Directors voted Sept. 7 to take administration of mental health services for a majority of the health plan’s members in-house, including responsibilities like contracting with mental health providers, processing reimbursement claims and overseeing therapy programs for patients with autism. Patients still will see outside specialists for treatment. This will be the third time in three years the agency has made a major change in the management of its mental health services, and the change comes just one year after the agency approved its original contract with Magellan. … CalOptima is the federal and state financed health plan for about 800,000 county residents, roughly a quarter of the population. … The change was prompted in part by a contract dispute between CalOptima and Magellan in July, which may have left some patients without mental health care for nine days when the company refused to process Medi-Cal payment claims. …