Latest California Healthline Stories
Complaints, Specialty Services at Issue in Healthy Families Transition
State health officials said some of the official numbers may be a little low in monitoring the transition of children from Healthy Families to Medi-Cal managed care plans.
At last week’s meeting of the Managed Risk Medical Insurance Board, MRMIB executive director Janette Casillas said that, having overseen the Healthy Families program for so long, she sees some anomalies when looking at recent transition-monitoring numbers from the Department of Health Care Services.
“My observation in reviewing the monitoring is that the data appears to be understated,” Casillas said, referring to the low number of complaints and grievances DHCS has reported it received during the transition. Casillas said the few complaints received by the department could mean the bulk of complaints are going elsewhere.
School-Based Health Center Proponents Lobbying for Funding
Supporters of school-based health centers are lobbying Congress to approve $50 million for such facilities. At the same time, California proponents, who expect the state to get about $8 million if the money is approved, are working on funding possibilities in Sacramento.
Attorney: Decision Overdue In Suit Challenging Medi-Cal Disabled Cuts
A federal judge is “about to decide” a case with large ramifications for the developmentally disabled community. William McLaughlin, an attorney representing The Arc of California, a national disabled-rights group, said a final ruling from U.S. District Court judge Morrison England is coming “any time now.”
In a Jan. 24 hearing, McLaughlin argued for a preliminary injunction to halt the rate reductions. He contends a decision is overdue.
“We have not obtained any injunctive relief so far,” McLaughlin said, though a federal judge had issued a stay for a period of time. That stay was lifted by Judge England in August, which means providers have been absorbing the cuts since then. And not very well, McLaughlin said.
Bill Aims To Reverse 10% Provider Rate Reduction
Assembly member Luis Alejo (D-Salinas) yesterday said he wants to undo the 10% Medi-Cal provider reimbursement rate cut passed by the Legislature in 2011. The across-the-board reductions were challenged in a lawsuit still pending in federal court and have not taken effect.
California lawmakers in 2011 faced a huge budget shortfall, and this particular cut was made to save the state an estimated $50 million a month, health officials say. Physicians and other providers of Medi-Cal services have been leery of this further reduction, when California already ranks near the bottom in the nation in Medicaid reimbursement rates.
Alejo said he will expand AB 900 — a bill originally designed to reverse rate reductions to one small group of providers — to include all providers affected by the 2011 cut. That includes physicians, pharmacists, hospitals and ambulance services, he said.
“We want to really take a step back and look at the 10% cut to all providers,” Alejo said. “Medi-Cal providers in California already have some of the lowest rates in the country. We are ranked 47th in the nation right now, even before that cut.”
Competition Spurs Northern Expansion in San Diego
Health care providers are expanding their reach in San Diego’s wealthier northern communities as declining reimbursements and changes to the delivery system under the Affordable Care Act alter the economic environment for health care.
New Bill Proposes Insurer Fee to Expand Residencies
An Assembly committee yesterday approved a plan to provide a major boost to California’s physician-training residency programs by generating roughly $100 million a year with a $5-per-covered-life fee to be imposed on health care insurers.
The new bill is one of several legislative efforts to address a provider shortage in California that’s likely to intensify when the Affordable Care Act is implemented and Medi-Cal is expanded starting in 2014.
AB 1176, co-authored by Assembly member Raul Bocanegra (D-Pacoima) and Assembly member Rob Bonta (D-Oakland), would expand the number of resident physicians in California by an estimated 1,000 with the expectation that new physicians would remain in California and practice in the underserved areas where they fulfilled their residency training.
Arkansas Medicaid Plan May Not Change Game After All
The state’s alternative plan for Medicaid expansion has received a great deal of attention. What did we ultimately learn?
Pre-Existing Conditions Bill Up for Final Vote
The Senate Committee on Appropriations yesterday unanimously approved ABX1-2 by Assembly member Richard Pan (D-Sacramento), the bill to ban pre-existing conditions as a means of denial for health coverage. It now heads to the Senate floor for a final confirmation vote.
The bill already passed the Assembly, so Senate confirmation would be its ticket to the governor’s desk. Brown Administration officials have said they support the bill.
It’s the first of the set of bills in the special health care legislative session to reach the final vote stage.
Advocates Push for Expansion Compromise
The Legislature last week moved two key components of the special session bills on health care reform. SBX1-2 by Sen. Ed Hernandez (D-West Covina) and ABX1-2 by Assembly member Richard Pan (D-Sacramento) passed through committees of the opposite house. Bothbills make changes to the individual health insurance market.
The Assembly Committee on Health approved SBX1-2, and it’s now going to Appropriations; and ABX1-2 moved through the Senate Committee on Health on its way to Senate Appropriations. Both bills were approved in floor votes in their own house so they are nearing final approval.
Also last week, a Senate floor vote unanimously approved SBX1-3 by Sen. Hernandez, the bridge plan to help people move from Medi-Cal to the exchange more easily. That bill now moves to the Assembly.
Telehealth Project Brings ‘Virtual Dental Home’ to Patients
A “virtual dental home” project from the University of the Pacific’s school of dentistry is using telehealth technology to bring dental services to nearly 800 low-income and special needs children in San Mateo County.