Bill for CMS Waiver Extension Quietly Heads to Governor for Signature
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Bill for CMS Waiver Extension Quietly Heads to Governor for Signature

A bill designed to extend California’s CMS waiver process made it through committee and then a floor vote in the final moments of this year’s legislative session.

On Friday, Sept. 11, the state Senate Committee on Health approved SB 36 by Sen. Ed Hernandez (D-West Covina) and that same day, it passed concurrence on an Assembly floor vote and then a Senate floor vote.

The bill originally required the the Department of Health Care Services to submit a waiver application to keep the duals demonstration project — for people dually eligible for Medicare and Medi-Cal — going, but the bill was amended to simply authorize DHCS officials to submit an application for waiver extension, should that prove necessary.

The current $10 billion “Bridge to Reform” 1115 federal waiver is due to expire Oct. 31. The state has submitted an application to create a new $17 billion waiver that includes a number of payment and delivery system reforms.

However, if negotiations for that new waiver take too long, state legislators won’t be in session at the time the waiver is due to expire. That’s where SB 36 comes in.

“This bill does two things,” Hernandez said at the Senate Health committee hearing. “It allows DHCS to request one or more temporary waiver extensions. And second, it requires the department to extend the existing hospital payment methodologies under the current waiver.”

That means hospitals would not find themselves in a no-man’s-land without a federal agreement if the state/federal talks stall for any reason.

The current hospital agreement would continue to provide essential safety net services in the event of a delay,” Hernandez said.

“The waiver allows the state to make payment streams available to public hospitals,” said Terri Thomas, legislative advocate for the California Association of Public Hospitals and Health Systems.

“Public hospitals are financed in a unique way, and the waiver’s a part of that,” said Michelle Cabrera, research director at the Service Employees International Union (SEIU). “Waivers are negotiated between the state and federal government and as such they can be unpredictable in terms of their timing and resolution.”

The bill passed unanimously with every vote: Health committee on a 9-0 vote; Assembly floor 78-0; and the Senate floor 40-0.

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