{"id":681010,"date":"2026-09-09T22:29:31","date_gmt":"2026-09-09T22:29:31","guid":{"rendered":"https:\/\/www.europesays.com\/ie\/681010\/"},"modified":"2026-09-09T22:29:31","modified_gmt":"2026-09-09T22:29:31","slug":"health-net-must-extend-assisted-living-benefits-state-says","status":"publish","type":"post","link":"https:\/\/www.europesays.com\/ie\/681010\/","title":{"rendered":"Health Net must extend assisted living benefits, state says"},"content":{"rendered":"

By Kristen Hwang<\/a>, CalMatters<\/p>\n

This story was originally published by CalMatters<\/a>. Sign up<\/a> for their newsletters.<\/p>\n

California regulators ordered Health Net to fix how it\u2019s handling the termination of assisted living services for low-income residents<\/a> after the insurer\u2019s abrupt decision left patients and providers scrambling. The state\u2019s corrective action plan requires Health Net to extend services for all members until the end of the year, rather than stopping some as soon as October.\u00a0<\/p>\n

Health Net, one of the largest Medicaid insurers in the country, notified providers several months ago that it was ending its assisted living and home care services contracts. The services are optional under Medi-Cal \u2014 California\u2019s version of Medicaid \u2014 meaning an insurer can decide annually whether it will continue coverage. Providers and family members said they got little or no warning, leaving them confused and panicked about finding other arrangements.\u00a0<\/p>\n

In an August letter to Health Net, the Department of Health Care Services cited eight deficiencies in the insurer\u2019s handling of the change, including failure to submit transition plans for members, failure to move members to other medically appropriate care, and denying services to members. Regulators wrote that violations \u201cjeopardize member safety, disrupt continuity of care, and endanger medically vulnerable members.\u201d\u00a0<\/p>\n

If Health Net does not extend benefits and create individualized transition plans for each affected member, the state may fine them $25,000 per member per day of violation, the letter states.\u00a0<\/p>\n

Advocates and providers estimate about 3,500 Medi-Cal patients rely on Health Net to pay for assisted living costs. Most are elderly, and many have cognitive issues like dementia. Health Net operates Medi-Cal plans in 10 counties: Amador, Calaveras, Fresno, Inyo, Los Angeles, Mono, Sacramento, San Joaquin, Stanislaus and Tulare.<\/p>\n

In a statement to CalMatters, Health Net spokesperson Beatriz Lopez said the company still plans to end the services next year, but will now cover all members through the end of the year.<\/p>\n

\u201cHealth Net and DHCS share a commitment to advancing the health and well-being of Medi-Cal members,\u201d Lopez said.<\/p>\n

Health Net has previously told CalMatters the assisted living benefit \u201chas not led to better care\u201d in terms of fewer emergency room visits or days hospitalized. The benefit is part of CalAIM, a broad state initiative to improve Medi-Cal services and save money by stabilizing high-cost users who frequently end up in emergency rooms. Lopez said Health Net would continue analyzing data and supporting services that result in better health outcomes.<\/p>\n

Providers confirmed to CalMatters that their contracts would run through the end of the year.<\/p>\n

Thousands still face January deadline<\/p>\n

Hagar Dickman, director of long-term services and supports at Justice In Aging, said the state\u2019s corrective action plan resolves the immediate crisis but fails to address the long-term problem: \u00a0\u201cThousands of older Californians are still set to lose their housing on January 1st.\u201d<\/p>\n

Allowing health insurers to cancel housing-related benefits creates problems, Dickman said, because most assisted living residents have no other home to return to. Additionally, the Department of Health Care Services has stated that if a member moves to another insurer that still covers assisted living, continuity of care protections would no longer apply, meaning the new insurer might not approve the member’s assisted living costs.<\/p>\n

“It\u2019s disingenuous to say there are protections and then say the protections don\u2019t apply,\u201d Dickman said. “So the option is skilled nursing or homelessness.\u201d<\/p>\n

Pauline Shatara, deputy director of California Advocates for Nursing Home Reform, agreed that state protections are inadequate.\u00a0<\/p>\n

\u201cIt doesn\u2019t sound like we found a solution to help pay for these people to remain where they are,\u201d Shatara said.<\/p>\n

Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more.<\/p>\n

This article was originally published on CalMatters<\/a> and was republished under the Creative Commons Attribution-NonCommercial-NoDerivatives<\/a> license.<\/p>\n","protected":false},"excerpt":{"rendered":"By Kristen Hwang, CalMatters This story was originally published by CalMatters. Sign up for their newsletters. California regulators…\n","protected":false},"author":2,"featured_media":681011,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":"","_share_on_mastodon":"0"},"categories":[275],"tags":[18,135,475,474,19,17,131718,5196],"class_list":["post-681010","post","type-post","status-publish","format-standard","has-post-thumbnail","category-healthcare","tag-eire","tag-health","tag-health-care","tag-healthcare","tag-ie","tag-ireland","tag-medi-cal","tag-seniors"],"share_on_mastodon":{"url":"https:\/\/pubeurope.com\/@ie\/117243449376449060","error":""},"_links":{"self":[{"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/posts\/681010","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/comments?post=681010"}],"version-history":[{"count":0,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/posts\/681010\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/media\/681011"}],"wp:attachment":[{"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/media?parent=681010"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/categories?post=681010"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/tags?post=681010"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}