CalOptima's OneCare Senior Program Free to Market and Enroll New Members

This marks an important step towards the launch of Orange County’s Cal MediConnect Program for Seniors
Monday, February 9, 2015

As a former member of the CalOptima Board of Directors and as current Vice Chair of the State of California’s Senate Committee on Health, Senator Janet Nguyen is proud to announce that all sanctions affecting CalOptima’s OneCare program for seniors have been lifted. The OneCare program coordinates medical services for 14,000 seniors who are eligible for both Medicare and Medi-Cal and found itself on hold due to concerns brought forth by the Centers for Medicare and Medicaid Services (CMS).

During her tenure at the CalOptima Board of Directors, Senator Nguyen worked diligently to ensure that the areas identified during the CMS audit were addressed.

“Upon learning of the results of the audit in January 2014, I acted immediately to ensure that seniors enrolled in the OneCare program were protected,” said Senator Janet Nguyen. “CMS’ decision to lift the OneCare sanctions is a testament of the great work performed by CalOptima Board Members, staff and providers alike. I commend everyone for their hard work to ensure that members continue to receive quality healthcare services.” 

CMS’ decision to allow CalOptima’s OneCare program to market and enroll to new members marks an important step towards CalOptima’s participation in the Cal MediConnect program, which would aims to create a single program that provides high quality, coordinated benefits for members that are eligible for both Medicare and Medi-Cal. CalOptima’s participation in that program will be determined after a final readiness review in the summer.

“In my capacity as Vice Chair of the Senate Committee on Health, I remain committed to providing access to quality health care and I am very proud of the care that CalOptima provides to Orange County’s seniors,” said Senator Janet Nguyen.

As representative of California’s Thirty-Fourth Senate District, Senator Janet Nguyen represents more than forty-percent of CalOptima’s membership. During Senator Nguyen’s tenure at CalOptima, the National Committee for Quality Assurance (NCQA) rated CalOptima as the top rated Medi-Cal plan in the State of California for 2014.