Deadline Set to End Federal High-Risk Pool
Managed Risk Medical Insurance Board officials yesterday outlined plans to deal with the federal announcement that the Pre-existing Condition Insurance Plan will not accept new applicants after March 2.
The federal PCIP program will continue to provide coverage for enrollees through the end of the year. The program will no longer be needed in 2014 when the Affordable Care Act provision that insurers may not deny coverage because of pre-existing conditions takes effect.
Janette Casillas, executive director of MRMIB, which runs the federally funded plan, said some prospective enrollees could apply for a similar, state-funded program called the Major Risk Medical Insurance Program.
State-Based Expansion Makes More Sense, LAO Says
After conducting a review of the two choices California officials are considering for optional Medi-Cal expansion, the state Legislative Analyst’s Office yesterday strongly recommended the state-based option, rather than a county-based plan.
On a busy Tuesday for health care policy in Sacramento, the Assembly Committee on Health yesterday convened the first hearing of the legislative special session on health care reform and passed the first component of it, AB 1X-1 by Assembly Speaker John Peréz (D-Los Angeles).
The proposed bill establishes the framework to expand Medi-Cal to childless adults under age 65 in California, up to 138% of federal poverty level. It would streamline the eligibility and enrollment process to follow the mandate of the Affordable Care Act, and offer California’s version of federally-required essential health benefits.
UC System May End Health Care Caps, Making New Bill Moot
A bill introduced last week, AB 314 by Assembly member Richard Pan (D-Sacramento), would eliminate fiscal caps on medical care for University of California students.
UC officials said they’re considering their own internal proposal to erase the caps, which would make the proposed legislation moot, but bill author Pan said he plans to go ahead with the legislation to ensure the rule is changed.
“It’s only fair that [UC students] should have the same protections as the rest of California,” Pan said, referring to provisions in the Affordable Care Act that prohibit lifetime caps on care. Even people in high-risk insurance pools had lifetime caps lifted last year.
Race, Gender, Age Lead to Disparities in Care
Health care providers from around the state gathered in Sacramento this week to examine disparities in medical care. They started by examining their own treatment of patients.
The annual conference of the California Association of Physician Groups took an unusual approach Wednesday to improving care, focusing on possible misconceptions or biased treatment by physicians of some patients.
The conference looked at possible disparities in treatment of Muslims or other culturally different patients, bias based on appearance and even bias toward patients who can’t be cured.
Standards Release a ‘Milestone’ for Exchange
Covered California, the state’s health benefit exchange, yesterday released its benefit standards outlining the basis for choosing qualified health plans that will participate in the exchange.
“This is another milestone for the exchange,” said Diana Dooley, secretary of the state Health and Human Services Agency. “We have a lot of hurdles to get over, we still have a lot to do, but this is another successful milestone toward the health care reform effort.”
Covered California also submitted an intention to file emergency regulations with the Office of Administrative Law last week, outlining its pediatric dental benefit policy. The exchange is expected to file those regulations Friday, according to Brandon Ross, staff counsel for Covered California.
New Health Care Bills Introduced
One source of funding for pediatric trauma care could get a boost from a new bill being introduced in the state Senate, according to the author of SB 191, Sen. Alex Padilla (D-Pacoima).
“Pediatric trauma care is still not widely available in California,” Padilla said, referring to the 14 pediatric trauma care centers in the state. “SB 191 would provide essential funding for emergency care and pediatric trauma care throughout California.”
The pediatric trauma care bill makes permanent a temporary penalty imposed by counties on vehicle code violations, at a rate of $2 for every $10 in fines. That penalty is due to expire at the end of 2013. Padilla wants to eliminate a sunset date and make it permanent.
Preventive Dentistry Plan Shows Results
The dental outreach plan for the 860,000 California children in the Healthy Families program has shown strong results, including across-the-board improvement in health plans’ prevention efforts, according to officials from the Managed Risk Medical Insurance Board, which oversees the program.
“Every one of our health plans showed improvement in terms of prevention,” said Janette Casillas, MRMIB’s executive director. “That means improvement in the number of oral exams, and in prevention efforts such as using sealant.”
Among the report’s highlights:
Medicare Drug Savings in California Estimated at $454 Million Over Two Years
California seniors and the disabled saved about $454 million on prescription drug costs in the past two years, according to an annual report on Medicare released by CMS Thursday.
According to federal officials, almost 300,000 Californians qualified in 2012 for the Part D Medicare coverage gap known as the “donut hole.” Last year, those beneficiaries saved roughly $183 million, the report said.
Those 300,000 Californians last year could buy covered brand name drugs at half price, and received a 14% discount on generic drugs. Savings for both types of prescription drugs will increase over time, the report said, until the coverage gap is closed.
Health Reform Benchmarks Linked to FQHCs
Federally qualified health centers (FQHCs) already have shown some of the results pursued by the Affordable Care Act, according to a study released this week by the California Primary Care Association.
The CPCA commissioned researchers to compare high-cost factors, such as hospital stays and emergency department use, as well as total cost of care, between FQHCs and non-FQHCs in California.
Some of the findings from John Snow, Inc. Health Services Division, a public health research firm based in Boston, were released Monday and showed enviable differences in FQHC care:
Higher Profile Coming to Exchange
California’s health benefit exchange is nearing its move into the mainstream public spotlight — but there is a lot of work still ahead, according to experts who gathered in Sacramento yesterday for a roundtable discussion of the exchange.
Yesterday’s symposium, called “Covered California: The Challenges and Opportunities of California’s Health Benefit Exchange,” was presented by the University of Southern California’s Price School of Public Policy and the USC Schaeffer Center for Health Policy and Economics and Quintiles.
Assembly member Richard Pan (D-Sacramento) acknowledged that creation of the exchange has helped place California at the head of the health care reform pack, but he said that leadership role doesn’t change the 2014 deadline that’s looming for health care reform and the exchange.