Latest California Healthline Stories
Plan for Autism Medi-Cal Benefit Rejected
State officials eliminated a plan to cover applied behavioral analysis — known as ABA therapy — as an essential health benefit for autistic children in Medi-Cal.
Bill Would Extend Private Plan Requirement To Cover Autism Therapy
An Assembly committee this week approved a bill to extend a requirement that private health insurers include a form of autism therapy in their California benefit plans.
Yamada Takes a Lonely Stand on ADHC Bill
A proposed bill to protect adult day health services was opposed by the people it was designed to benefit, and the author refused any amendments. Predictably, lawmakers rejected the bill.
Committee Finally Moves Health Reform Bills
The Assembly Committee on Health yesterday approved passage of two bills that made up the bulk of policy decisions in the legislative special session on health care.
Yesterday’s committee approval came the day after the Legislature and Gov. Jerry Brown hammered out a budget agreement. Some details of that pact have not been officially announced, including a provision for coverage of autism services. Autism coverage is implicitly contained — but could still be dropped — from one of the bills passed by the committee yesterday.
SBX1-1 by Sen. Ed Hernandez (D-West Covina) would implement optional Medi-Cal expansion, paving the way for 1.4 million Californians earning up to 138% of federal poverty level to become eligible for the state’s Medicaid program.
Autism Therapy Out of the Budget
Several health care provisions were conspicuously absent from the Legislative Budget Conference Committee’s budget agreement with Gov. Jerry Brown announced yesterday. The plan has no mention of repealing a 10% Medi-Cal provider rate cut nor a plan to fund autism services.
The agreement omitted a proposal to set aside $50 million in general fund money to pay for autism services. When matched with federal dollars, the state would have had $100 million to help pay for autism treatment, including applied behavioral analysis therapy, known as ABA therapy.
Whether ABA therapy will be covered as an essential health benefit starting in 2014 is still up in the air, but yesterday advocates were assuming the worst.
State ‘De-links’ Mandatory Enrollment from Duals Project
The Department of Health Care Services last week announced a new provision of Cal MediConnect that would establish a means of abandoning the state’s duals demonstration project if it doesn’t meet a financial benchmark.
The department also wants to “de-link” mandatory enrollment from the demonstration project, according to Jane Ogle, deputy director at DHCS.
“On the program side, we de-linked mandatory enrollment of duals. That way, we’ll have long-term services and supports as Medi-Cal benefits,” she said.
DHCS Transparency Bill Moves Forward
The Senate Committee on Health this week approved a bill that would set new standards of accountability and transparency at the Department of Health Care Services.
AB 209 by Assembly member Richard Pan (D-Sacramento) received unanimous committee approval Wednesday and now heads for a Senate floor vote, the step before it can be sent to the governor’s desk.
The bill wants to hold the department accountable for problems that arise with patients moving to Medi-Cal managed care plans with stronger, measurable benchmarks, Pan said.
Reversing Medi-Cal Cuts Priorty for Latino Lawmakers
Members of the legislative Latino Caucus on Tuesday laid out their agenda that includes some form of reversal of the 10% reduction in payments to Medi-Cal providers.
The Legislature passed the 10% cut in 2011, but it was delayed until a federal appeals court ruling upheld the reduction two weeks ago. State officials said the bulk of the cutbacks will begin in September.
Although the case may be appealed to the U.S. Supreme Court, the federal appeals court ruling May 24 puts pressure on the Legislature to come up with an alternative. Some lawmakers — including the Latino Caucus — have been working to craft a legislative answer. Two members of the Latino Caucus in particular have been front-and-center in efforts to reverse the rate cuts.
Protesters Swarm Sacramento to Protest Medi-Cal Cuts
The Capitol yesterday swarmed with protesters upset about a 10% cut in reimbursements to Medi-Cal providers that has raised concerns about the state’s ability to provide access to Medicaid beneficiaries.
“Health care, especially in the hospitals, it’s not always working,” said Sonia De La Torre, a hospital worker who got on a bus at 4 a.m. yesterday in Corona (Riverside County) to attend the Sacramento rally. “When people come into the hospital with no insurance, they get basic care, at best. We want to make sure people get treatment.”
Police estimated 8,000 people gathered outside the Capitol Building yesterday. Musicians took the main stage early in the day, replaced later by speakers including event organizers and legislators.
Budget Process Latest Way to Reverse Cuts
Thousands of providers, patients, health care professionals and other protesters are expected to gather today outside the Capitol Building to support the idea of reversing a 10% Medi-Cal provider rate cut. Organizers say it will be the largest health care protest in Sacramento history.
“We have people hopping on buses in Oceanside at 4 in the morning to get here,” said Molly Weedn, director of media relations for the California Medical Association. “People are coming from all over the state, and we’ve seen support from both sides in the Legislature. All of this [support] shows that the public doesn’t want Medi-Cal to be cut, so that’s why we’re doing this.”
It has been a tough couple of weeks for proponents of reversing the rate cut made in 2011 and not yet implemented because of court battles.