Bill Aims to Expand Number of Residency Slots
Most of the health care reform expansion effort has focused on the logistics of adding coverage for up to 3 million more Californians, but that’s just the start, according to Senate member Michael Rubio (D-Shafter). Those millions of health insurance cards won’t be worth their weight in plastic if you don’t make sure the state has the providers to take care of all of those people, he said.
“Even if we resolve the issue of health insurance,” Rubio said, “health access still is a significant issue.”
Rubio spoke on the Senate floor last week on behalf of his bill to expand the number of residency slots in California, a plan with the potential to significantly increase the number of providers in the state, he said. Setting up the infrastructure to accept private contributions for residency expansion creates an opportunity to add providers in California without using any more general fund dollars, Rubio said.
State Health Officials Intrigued by New Medi-Cal Data
Len Finocchio is a numbers guy, so he’s genuinely excited by a new set of survey data that paints a picture of recipients’ impressions of the Medi-Cal program.
“There is lots of data, lots of it,” said Finocchio, associate director of the Department of Health Care Services. “We will be continuing to mine it for a long time, to get insights about how to make the program better.”
Last week, the California HealthCare Foundation, which publishes California Healthline, released a survey of the attitudes and concerns of Medi-Cal beneficiaries. It has been a relatively long time since a similar survey was completed in 2000, so state health care officials were extremely pleased to get updated information, Finocchio said.
Duals Project Goes to CMS for Approval
It was a big moment for officials in the Department of Health Care Services.
“We are thrilled to be getting this in,” said Jane Ogle, deputy director of DHCS. “It’s a big project. So to get this in, we’re all really excited. This is the result of a year’s planning, a year of planning and work with advocates and stakeholders and within the department. And all of that comes together in this document.”
The project is the Coordinated Care Initiative, also known as the duals demonstration project, and the document is the project’s final plan, which was submitted late last week to CMS.
Flu Vaccine Bill Approved by Senate
There’s more than one kind of resistance to the flu virus.
Senate member Lois Wolk (D-Davis) found that out, and Wednesday introduced to the Senate floor a substantially reworked version of her bill, SB 1318, which would require health care facilities to meet a 90% flu vaccine health-worker compliance rate by 2015.
The bill passed on a 23-9 vote. However, that vote came at a price.
Pre-Existing Condition Reform Passes
When state Sen. Ed Hernandez introduced his bill SB 961 to the Senate floor yesterday, the West Covina Democrat’s speech was laden with the historic nature of the legislation.
“As we all know, on March 23rd of 2010, the president of the United States of America signed into law the comprehensive health care reform bill known as the Patient Protection and Affordable Care Act,” Hernandez said.
“I feel tremendous responsibility to ensure that California continues to lead the nation in implementing federal reform,” he said, “and that we serve as a model for the rest of this country.”
CMS Weighs in on Enrollment Question
Federal health officials have informed the state that CMS would favor passive enrollment with an opt-out provision but it does not support lock-in enrollment for the dual-eligible demonstration project in California.
That’s according to Kevin Prindiville, deputy director of the National Senior Citizens Law Center in Oakland, who spoke to CMS officials on Friday.
“CMS has told us that’s all they will allow,” Prindiville said. “It’s not a big surprise, but it’s very welcome. We think the passive enrollment system is problematic in some ways, but CMS has said all along they would allow passive enrollment, but there would have to be a way to opt out at any time.”
Community Dental Beneficiaries Go to Liberty
Community Dental Services health plan, plagued with financial troubles and quality-of-care problems, has shut down its managed care dental plan in Sacramento and Los Angeles counties.
On Friday, the state announced that all 16,000 Medi-Cal beneficiaries at CDS, the bulk of them in Sacramento County, would switch to Liberty Dental Plan of California. Also making the change will be 4,000 non-Medi-Cal patients. State officials said beneficiaries’ providers would remain the same in almost every case.
The failure of CDS may be good news for the state and the beneficiaries in the plan, since that company had the lowest utilization rate among the five health plans providing dental coverage in Sacramento County. The state has been under fire recently because of low utilization rates in the pilot “geographic managed care” system. In the 2010-2011 fiscal year, fewer than one-third of Sacramento County Medi-Cal children went to a dentist, compared with a utilization rate of nearly 50% for the rest of the state.
State Proposes Delaying Start Date For Budget Cuts
The state is planning to delay the starting date for budget cuts by switching implementation from the start of the year to calendar year, according to a Department of Health Care Services summary of possible changes to trailer bill language for the May budget revision.
That’s one of many revisions outlined in the summary. The DHCS changes reflect input and concerns from stakeholders.
Subcommittee Puts Co-Pay Idea on Hold
Co-pay is back. Last year, the Legislature passed and the governor signed a budget trailer bill that included Medi-Cal co-payments of $5 for some provider visits, up to $50 for emergency department visits and up to $100 for patients admitted to the hospital.
That move required a CMS waiver but in February, federal officials denied it. Now, with the May budget revision, a scaled-down version of co-payments is back on the table.
Yesterday, an Assembly budget subcommittee heard testimony on the subject and decided to hold co-pay approval for a later date.
Kaiser Balks at Joining Healthy Families Conversion to Medi-Cal
The planned switch of Healthy Families children into Medi-Cal could leave as many as 43,000 children looking for new health care providers if the state can’t convince Kaiser Foundation Health Plan to join the effort.
That number would grow to 189,000 children if the state eventually converts all Healthy Families children to the Medi-Cal program.
On Tuesday, the Senate budget subcommittee for Health and Human Services rejected a plan to move the entire Healthy Families population of 875,000 kids to Medi-Cal all at once, instead starting with a pool of roughly 200,000 “bright line” children — beneficiaries who are at or below 133% of federal poverty level.