What is the CMSP and who administers it?

The CMSP is a medical program for Medically Indigent Adults (MIAs) who do not qualify for Medi-Cal. The CMSP is only available in counties with small populations.

Effective January 1, 1983, the responsibility for providing health care for MIAs, age 21 through 64 is with the county in which the MIA resides. Counties with a population of less than 300,000 have the option of contracting with the CDHS to administer services for MIAs under the CMSP. CMSP annually negotiates contracts to care for MIAs who are eligible in the contract counties.

At present, the following counties have contracts for the CDHS to administer services: Alpine, Amador, Butte, Calaveras, Colusa, Del Norte, El Dorado, Glenn, Humboldt, Imperial, Inyo, Kings, Lake, Lassen, Madera, Marin, Mariposa, Mendocino, Modoc, Mono, Napa, Nevada, Plumas, San Benito, Shasta, Sierra, Siskiyou, Solano, Sonoma, Sutter, Tehama, Trinity, Tuolumne, and Yuba.

Eligibility for CMSP is determined by the counties. There is no state hearing jurisdiction for CMSP eligibility issues. Each county has its own hearing process.

In the 34 small counties listed above, the CDHS administers Medi-Cal. Treatment Authorization Requests (TARs) for CMSP are obtained through the appropriate Medi-Cal field office using Medi-Cal TAR forms. The CDHS handles authorization and payment of all medical services for CMSP recipients. There is jurisdiction to hear a scope of benefits issue for a CMSP recipient.

(Medi-Cal Pharmacy Provider Manual page 100-36-1 through 100-36-5).