As California begins to implement the Affordable Care Act (ACA), Medi-Cal is experiencing a re-design of its programs and delivery system.
The Department of Health Care Services (DHCS), in partnership with the Centers for Medicare and Medicaid Services (CMS), has initiated special waiver and demonstration programs designed to bring the state in line with the goals of federal healthcare reform.
The state is proactively moving toward healthcare reform using the Medi-Cal managed care network as a key element, and re-configuring many programs with the Medi-Cal managed care delivery system at the core.
Re-designed Medi-Cal programs in 2013 include:
that is being established at the local level in California and the waiver program brings additional federal funding to California. 
On April 11, 2012, as required by the Affordable Care Act, the Secretary of Health and Human Services (HHS) submitted a proposal to Congress to reform Medicare’s wage index. After considering the studies and recommendations executed by the Medicare Payment Advisory Commission (MedPAC) and Acumen LLC, DHHS is proposing to implement a Commuting Based Wage Index (CBWI) system.
The California Department of Health Care Services (DHCS) began receiving claims on July 1 for the newly established Code 19 rate. Similar to the Code 18 rate for Medi-Cal Managed Care services, Code 19 will be imbedded into the prospective payment system (PPS) rate for services provided by FQHCs and RHCs to beneficiaries of the Children’s Health Insurance Program(CHIP). The Code 19 rate equals the difference between what the clinic receives for Healthy Families services and their Medi-Cal PPS rate.