5225-184 CalAIM-Medi-Cal Reimbursement System (MCRS)

The California Correctional Health Care Services (CCHCS), Information Technology Services Division (ITSD) currently maintains the information technology infrastructure and medical grade network that enables our clinical staff to provide continuity of care to the justice-involved residents. Assembly Bill (AB) 133 requests federal authority to implement the California Advancing and Innovating Medi-Cal (CalAIM), a framework that encompasses broad-based delivery systems, and payment reform across the statewide Medi-Cal program. Currently, CCHCS does not have a billing/notification claim system and proposes to develop a new billing/notification system to receive federal reimbursement for CalAIM services and medications to comply with AB 133. As a result, a new Medi-Cal billing claim system is needed to be developed and integrated with multiple state, county, and third-party entities no sooner than April 1, 2024, with a 24-month implementation window to be compliant with AB 133. It is estimated that the state will receive federal reimbursements of $10.8 million annually.

Project Details

IPOR Reporting Period	Overall IPOR Rating
07/01/2025 - 07/31/2025	Green

Independent Project Oversight Dashboard

Key Questions

Is the project on track to satisfy the customer's business objectives?Yes

Is the project on track to achieve the objectives in the approved timeframe?Yes

Is the project on track to achieve the objectives within the approved budget?Yes

Project Overall Health	Comments
Green	• The overall health of the project health is Green, as the project is progressing according to timeline. Budget and scope are in alignment with approved baseline. •There are no major risks, issues or decisions that need to be escalated.

Focus Area/Rating	Comments
Governance Green	• The project’s governance practices align with the current approved Governance Plan. • The program/business representatives are actively engaged and empowered to ensure that the project brings value to the program/business.
Time Management Green	• The project is on schedule. • Sprints 150 and 151 were completed in July 2025. • Phase 3 was successfully implemented on July 21, 2025.
Cost & Contract Management Green	• The project has a contract management plan and cost management plan that are being followed. • Total One-Time IT project cost is budgeted at $9,592,381 and $6,467,738 has been spent.
Scope Management Green	• The scope is being managed according to the Scope Management Plan. • The project is on target to meet its objectives as outlined in the Project Approval Lifecycle (PAL) process.
Resources Green	• The project continued to actively manage its resources. • The ITS 2 – IT Server resource was onboarded. • Staffing management and contractor management practices are being implemented in accordance with the Staffing Management Plan.
Quality Green	• The Product Owners and the project’s State Agile Team are involved in quality processes, including testing activities. • IV&V provides monthly reports and assessments on the deliverables. The reports are comprehensive and provide easy to implement changes for the project’s health.
Risk And Issues Green	• The RAID is being updated weekly. • The project team is adhering to risk and issue monitoring practices identified in the Risk Management Plan. • All Risks and Issues were closed during the reporting period.
Transition Readiness Green	• Phase 3 Training/Organizational Change Management activities continued.
Conditions For Approval Green	• IV&V vendor on board - Condition met.
Corrective Action Green	• No corrective action plans are in place.

20250626 Release-16