The Medical Services Initiative (MSI) is a
mandated, State and County funded safety-net program,
responsible for the provision of medical care to Orange County’s
medically indigent adults, previously covered by the Medi-Cal
program.
The program covers medical care for Orange
County residents 21 through 64 years of age who have a current,
urgent or emergent medical need, and limited or no financial
resources to pay for their healthcare.
Financial eligibility is based on Medi-Cal
criteria, with an income cap at 200% of the Federal Poverty
level. Proof of Orange County, and U.S. citizenship or legal
permanent residency is required.
The scope of covered benefits includes,
primary care and disease prevention; early intervention to help
stop the spread of disease; immediate treatment of acute
exacerbation of chronic conditions that are potentially life
threatening; and treatment of conditions that would otherwise
result in significant and permanent impairment in health status
and/or function.
The MSI division of the Health Care Agency is
the payer and administrator of the MSI program.
The MSI program contracts with a variety of
private entities for the provision of medical and surgical care.
These contracts include: hospitals, surgery centers, skilled
nursing facilities, urgent care, imaging, laboratory, pharmacy,
administrative services and case management. Payment provisions
are included for physician/community clinics, durable medical
goods, home health and emergency transportation.
The MSI Division of the Health Care Agency
also administers separate, non-mandated, indigent medical
services programs, County-wide. These Programs include:
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The California Healthcare for Indigents
Program (CHIP). This Program is funded through surtax on
cigarettes and tobacco products; and provides funding to
hospitals, physicians and community clinics based on
uncompensated care provided to individuals not eligible for
MSI or any other government-funded program.
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The Emergency Medical Services Fund (EMSF).
This Program is funded primarily, through penalty
assessments on penal code violations; although a small
portion of funding comes from surtax on cigarettes and
tobacco products. EMSF provides compensation to physicians
and trauma hospitals for emergency department services, when
no other source of payment, (public or private) is
available.
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