Latest California Healthline Stories
State Loses Bid To Cut FQHC Rates, Restructure Pay System
Two budget subcommittees recently rejected an attempt by the state Department of Health Care Services to rework the way it pays federally qualified health centers and rural health clinics. The proposal included a funding cut of 10%, or about $100 million, to those centers.
Should California Reconsider Health Care Districts?
With the Affordable Care Act poised to dramatically change the state’s health care system, should California be reconsidering special health care districts that generate and consume millions of dollars every year? We asked experts to weigh in.
Welfare to Work Seen As Health Issue
Phil Ansell, director of the Los Angeles County Department of Social Services, has watched funding for the CalWORKs program diminish over recent years. At an Assembly hearing late last week, Ansell held both hands apart, as if measuring a decent-sized fish in the air.
“If this balloon is our welfare-to-work program,” he said, then moved his hands closer together, “we have managed to shrink it without tearing it.”
If the governor’s recently proposed cuts to CalWORKs go through, though, Ansell said it’s likely that balloon will pop.
Health Care May Play Part in California Political Makeover
With retirements on both sides of the aisle, new congressional districts and new voting rules, California’s political makeup is headed for change in both Washington, D.C., and Sacramento. A couple of health care issues — a controversial Medicare plan in Congress and a state ballot proposal to regulate health insurance premiums — could play a part in how those changes happen.
Adult Day Health Services Budget Looks Familiar
The recent state budget proposal includes the expected cost of the Community-Based Adult Services program for next year: roughly $83 million.
That number is eerily close to last year’s budget estimate for the Keeping Adults Free from Institutions program, which was an alternative adult day services plan that the Legislature passed in June. The Legislature approved $85 million for the KAFI program, which was designed as a half-price replacement for the adult day health care program.
Gov. Jerry Brown (D) vetoed KAFI.
Cuts, Policy Changes at Healthy Families Program
The most recent state budget proposal includes a variety of cost-saving measures in the Healthy Families program — reduced reimbursement rates, higher premium prices, higher copays and a transition of its 877,859 children into managed care plans by the end of June 2013.
At yesterday’s monthly meeting of the Managed Risk Medical Insurance Board, chief deputy director Terresa Krum broached the bad news.
“There are a number of significant budget assumptions,” Krum said. “So first, the budget proposes to reduce the per-member, per-month rates paid to health plans in Healthy Families to the average Medi-Cal rate.”
Newly Enacted State Legislation Looks Toward Implementation of Federal Health Reform Law
John Arensmeyer of Small Business Majority, Diana Dooley of California’s Health and Human Services Agency and Anthony Wright of Health Access spoke with California Healthline about California’s efforts to prepare the state for changes under the federal health reform law.
Medical Transport Lawsuit Gets Federal Injunction
A federal judge issued a preliminary injunction Wednesday to halt a 10% Medi-Cal provider reimbursement cut to medical transportation services.
It was the third time the state has lost in court on this issue. State officials said the state will appeal. Preliminary injunction rulings at the end of December halted cuts in hospital and pharmacy services. Another lawsuit, brought by the California Medical Association and other providers, is still pending.
Marat Sheynkman, executive director of the California Medical Transportation Association, which filed the suit that triggered Wednesday’s ruling, said the 10% Medi-Cal reimbursement cut would have hit medical transport providers particularly hard.
Communities of Color Hit Hardest by Health Cuts, Advocates Say
Health care officials and advocates expressed serious concern over Democratic Gov. Jerry Brown’s latest round of budget proposals that include reductions to community clinics, hospitals, and programs such as Healthy Families and CalWORKs.
“We have much more need than resources to provide for it,” Diana Dooley, secretary of California’s Health and Human Services Agency, said in a conference call with stakeholders. “I fully understand your concern. These are consequential reductions. All of these cuts have consequences.”
Both health officials and advocates seem a little weary of the constant and continued reductions. According to Ellen Wu of the California Pan-Ethnic Health Network, acknowledging that the reductions are hard is getting a little harder to hear.
Disabilities Case Waits on Supreme Court Ruling
A federal judge last week issued a stay of a court case challenging the freezing of some provider reimbursement rates for services for the developmentally disabled in California — effectively putting off the case until February or March, after the U.S. Supreme Court issues a ruling in a similar case it is currently hearing.
U.S. District Judge Morrison England Jr. denied the state’s request to dismiss the case. He also denied the plaintiffs’ request for a preliminary injunction on the rate freeze.
He cited a pending CMS ruling on health care provider costs that could also inform the court case. But the big one to wait for is the Supreme Court case, Douglas v. Independent Living Center, according to Tony Anderson of the Arc of California, which brought the case for the developmentally disabled.