County of San Diego Health and Human Services Agency HHSA County Medical Services CMS Program Guide Clinic Assignment Number Page 0208 1 of 2 Background Upon approval the worker asks the beneficiary to pick one of the primary care clinics PCC that contract with CMS as a medical home The worker enters the PCC site in the CMS IT System which will be transferred to the CMS card and mailed to the beneficiary Policy A Assigning a Clinic The beneficiary chooses their PCC site at approval When the beneficiary is not able or available to select a PCC site the worker will designate the PCC site based on the following factors PCC site closest to the beneficiarys address PCC site previously designated in IDX or Select the site based on information known as to where followup care would be given When the worker is aware that the beneficiary is a Native American the worker enters the information into the CMS IT System and gives the beneficiary the Health Services Information for Native Americans This form informs the beneficiary that they may choose to receive their health care coverage through the CMS PCC they selected as part of the CMS enrollment process andor a participating Indian Health Clinic B Changing Clinics When beneficiaries want to change their primary care clinic because they have moved or prefer a clinic closer to their home or work they can ask the worker to change the clinic designation The worker will input the new PCC site into CMS IT System which will up load to IDX the next business day A new CMS card will not be mailed to the beneficiary as the providers have access to the eligibility and PCC site via the POV site When beneficiaries are dissatisfied with their primary care clinic they must call the CMS Patient Information Line 858 4924444 The ASO will evaluate what is causing the dissatisfaction and will inform the worker to change the clinic in the CMS IT System if appropriate C Discharged From a Clinic When a beneficiary has been discharged from a clinic because of problems or conflicts with the clinic staff that cannot be resolved the worker will direct the beneficiary to select another clinic The worker will write in the comment section of the CMS IT System discharged from clinic name and date and sends the information to the ASO This information will become an alert in IDX that this beneficiary cannot select this particular clinic as a medical home The beneficiary will receive written notification from the clinic stating that she can no longer get services there Other Program Impact None References None County of San Diego Health and Human Services Agency HHSA County Medical Services CMS Program Guide Clinic Assignment Number Page 0208 2 of 2 Sunset Date This policy will be reviewed for continuance by 04302019 Release Date April 04 2016