Latest California Healthline Stories
Federal Court Upholds 10% Medi-Cal Provider Cut
The United States Ninth Circuit Court of Appeals on Friday upheld the right of California to impose a 10% rate reduction on providers of Medi-Cal services.
The long-awaited ruling is the last judicial step, short of the U.S. Supreme Court, for the controversial cut to hospitals, physicians, emergency transport and dentists. Provider groups have said they would likely appeal the rate reduction to the Supreme Court.
The federal ruling lifted the injunctions on implementing the reductions. Outside of a Supreme Court appeal, the federal judicial panel clearly stated there would be no further appeals considered.
‘Free Data’ Movement Gets Boost From Big Conference
The future is bright for real-life, real-time projects based on open-source health data, according to experts who gathered in San Francisco last week for the Healthy Communities Data Summit.
Exchange Rates Make ‘Great Day For California’
Covered California, the state’s health benefit exchange, yesterday announced a rate structure for its health insurance plans that came in at a much more affordable price than first projected.
That was great news for exchange officials and it accounted for much of the pomp around that rare circumstance during yesterday’s announcement.
“This is really a great day for California,” said Diana Dooley, secretary of the state’s Health and Human Services agency and chair of the Covered California board. “We have come a long way and we have a long way to go,” she said. “We are moving to make Californians healthier and give them the financial security they need.”
Task Force To Examine Developmental Centers
Diana Dooley, secretary of the state’s Health and Human Services agency, yesterday announced formation of a task force to take a hard look at the viability of closing four developmental centers in California.
“I don’t know if the four developmental centers we operate can all close,” Dooley said. “I want to hear from the stakeholders with an open mind. Clearly there is a problem with these centers, but we also have to address the fiscal issues. If they cannot operate, then we should look at a timeline for closing them.”
Developmental centers in California have come under fire recently — with allegations of chronic abuse of patients, investigations by multiple government agencies and loss of federal certification. The state has taken a number of steps, particularly at Sonoma Developmental Center, to investigate possible abuses and improve safety of the centers’ clients.
Exchange Premiums Closely Watched by Industry, Nation
“Everyone will be watching what goes on in California” this week, according to health insurance industry leaders. The state’s new health insurance exchange announced which insurers will offer coverage in Covered California and how much they’ll charge.
How Obamacare Could Change Medi-Cal For the Better (and Worse)
The Affordable Care Act will help boost Medi-Cal enrollment, which could lead to positive trickle-down effects for California, but observers warn that the program is already dealing with funding and access concerns.
San Francisco Leading the Way in Health Data Applications
The city of San Francisco is leading the way in using health data in innovative ways and it’s paying off in a big way, according to several city officials who spoke yesterday at the Healthy Communities Data Summit.
The summit was held in San Francisco and that meant a number of success stories were local, but the conference cast a wide net in its approach to innovation prompted by public release of health data.
“We have so many compelling examples of how free data can help health practices,” said summit panelist Cheryl Wold, owner of Wold and Associates, a community health consulting firm based in Pasadena. “More and more people are using that data to create health solutions.”
Game Changer: Obamacare’s New Coverage Rules And Costs
Q: I had colon cancer and have had trouble buying health insurance ever since. Under Obamacare, will insurance companies still be allowed to refuse me because of my medical history? A. Finally, an Obamacare question with a simple answer, and the answer is NO. Starting on January 1, health plans no longer can deny anyone […]
Administrative Change for High-Risk Subscribers
The Pre-Existing Condition Insurance Plan (PCIP), a federally-funded, state-run interim program, is moving from state to federal oversight for the rest of the year.
A high-risk pool for people unable to secure health care insurance under pre-Affordable Care Act rules, PCIP is temporary because the new federal reform law prohibits insurers from denying coverage based on pre-existing conditions.
Now the “state-run” part of that program is also on its way out, as California will shift control and management of the program to federal officials, according to administrators at the Managed Risk Medical Insurance Board (MRMIB), which currently runs PCIP in California.
Federal Ruling, State Law May Conflict
In 2011, the Legislature went along with the governor’s plan to cut Medi-Cal provider rates by 10%. Provider groups immediately went to the courts to stop it, saying that patient access to care would be threatened by such a severe reduction. Now the final decision rests with a federal judge. A ruling is expected soon.
If a federal judge signs off on the law, Medi-Cal providers in California will have rates cut by 10% and also will need to pay back two years’ worth of that 10% reduction. The effect would be a 15% rate cut for the next four years and a 10% cut thereafter.
The 10% cut represents about $600 million a year to the California budget.