Senate, Assembly Subcommittees Discuss Health Plan of San Mateo, Other County-Run Medi-Cal Health Plans
The Senate and Assembly subcommittees on health and human services on Monday discussed future funding for county-run Medi-Cal health plans, including Health Plan of San Mateo, the San Mateo County Times reports (Hay, San Mateo County Times, 4/13). County supervisors said in March that they might terminate the contract with the HMO by July if they fail to find more money to shore up the program. Health Plan of San Mateo is managed by the county in an effort to expand Medi-Cal beneficiaries' network of pharmacies, hospitals and doctors by providing higher reimbursement rates than traditional Medi-Cal. It covers an estimated 43,000 Medi-Cal beneficiaries in the county. In October, health plan officials warned that they would be forced to cease operations unless the plan received government funding. The health plan is losing about $600,000 a month because medical inflation has outpaced state contributions. In addition, because the health plan contracts directly with the county, the county-run hospital is ineligible for federal subsidies that most public hospitals receive (California Healthline, 3/24). According to the Times, state officials are "budgeting as though Health Plan of San Mateo were already dead." San Mateo County Manager John Maltbie, citing a report from the Legislative Analyst's Office, said that the health plan had saved the state $150 million since its inception in 1987 and added that eliminating it would increase state and federal costs by $30 million a year. Maltbie said that many health care providers who currently treat Medi-Cal beneficiaries would drop out of the program if the county-run health plans were eliminated, thereby "limiting access to quality health care for Medi-Cal recipients." In addition to San Mateo County, Monterey, Napa, Orange, Santa Barbara, Santa Cruz and Yolo counties operate county-run Medi-Cal health plans, while other counties contract directly with the state for Medi-Cal administration (San Mateo County Times, 4/13).
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