Latest California Healthline Stories
‘So Many Moving Parts’ To Fit Together
The Department of Health Care Services announced this week that the Cal MediConnect duals demonstration project will not start until at least January, 2014, a delay from its previous expected launch date in October, 2013.
Advocates for seniors’ health care yesterday praised the decision, saying the extra three months will go a long way toward pulling all of the disparate pieces of Cal MediConnect into place.
“I think [the delay] comes from the general recognition that so many things have to happen, for so many people, speaking so many languages,” said Jack Hailey, project manager for Government Action and Communication Institute, and a contributor to the California Collaborative for Long Term Services and Supports.
Provider Cut Repeal Talk Turns to Veto Override
Two bills repealing the 2011 Medi-Cal provider reimbursement rate reductions have sailed through California legislative committees so far in an unusual way: They’ve been approved with unanimous votes in both houses from both parties.
But all those Yes votes could fail on a single No vote if Democratic Gov. Jerry Brown vetoes the bills. He has 50 million reasons every month to use his veto stamp. The savings to the state from the 10% across-the-board Medi-Cal provider rate cut amounts to an estimated $600 million a year.
Compromise Proposed for Medi-Cal Expansion
A new plan is expected to be unveiled today offering a compromise approach to the state’s optional Medi-Cal expansion.
Health Access California, a not-for-profit health advocacy organization came up with the plan as a bridge between the state’s rough outline in the budget for two choices — a state-administered or county-administered approach.
More than one million Californians will be newly eligible for Medi-Cal under the optional expansion to those people making up to 138% of federal poverty level. The federal government will pay 100% of expansion costs for the first three years, and 90% thereafter.
Medi-Cal Outreach Gets Big Boost
If the state won’t pay for it, one private donor will. The California Endowment yesterday committed $26.5 million to fund the state’s Medi-Cal expansion outreach under the Affordable Care Act.
The Assembly Budget Subcommittee on Human Services yesterday voted unanimously 3-0 to accept the contribution and directed state officials to apply for federal matching funds for a total of $53 million in outreach money.
“The success or failure of Obamacare will depend on how many will enroll,” said Daniel Zingale, senior vice president for the Endowment. “In this state, it’s enormously challenging. … We have more uninsured here than many other states have people.”
Snickers, Seriousness Expected for Junk Food Bill
This week, an Assembly committee will take up a plan to change the foods offered in vending machines in state buildings. No more empty calories for state workers, according to the proposed law.
AB 459 by Assembly member Holly Mitchell (D-Los Angeles) is scheduled to be heard Wednesday in the Assembly Committee on Appropriations. A similar bill authored by Mitchell last year stalled in committee. This year’s bill earned initial approval two weeks ago in the Business and Professions Committee.
According to Harold Goldstein, executive director of the California Center for Public Health Advocacy, the debate over the bill boils down to a fundamental issue.
Managed Care Tax Decision Left Until New Budget Proposal Arrives
Distrust ran high yesterday during part of a budget subcommittee hearing when the subject turned to reinstitution of a managed care organization tax.
The MCO tax instituted in 2009 had the singular distinction of being embraced by the ones being taxed because the money was matched by federal dollars and was used to support the Healthy Families program. In the long run, health insurers made their money back and the state had more federal dollars in its coffers.
The MCO tax expired in December. The Brown administration wants to keep it going with one big difference: Since the state eliminated Healthy Families, a transition that started in January and runs through the end of this year, the governor would like to put the MCO tax money into a rainy-day fund for the state.
Committee Votes To Repeal Medi-Cal Cut
Assembly member Luis Alejo (D-Watsonville) got a grand total of seven seconds to speak at Tuesday’s Assembly Committee on Health hearing before he was interrupted.
“AB 900 eliminates the 10% Medi-Cal reimbursement rate cuts for all Medi-Cal providers … ” Alejo started to say.
“Move the bill,” said committee member Roger Hernández (D-West Covina). And before Alejo could speak again: “Second!” said Assembly member V. Manuel Pérez (D-Coachella).
That set the tone at Tuesday’s hearing, which saw a unanimous, bipartisan approval of Alejo’s bill.
Home Services Workers Balk at Regulation
The Assembly Committee on Human Services yesterday voted to approve a bill designed to register and regulate home health care workers.
“An unknown number of independents operate without any oversight or regulation in California,” said Gary Passmore, who sits on the board of directors at the California Congress of Seniors. “AB 1217 requires both the owners and aides of the organization to pass a background check and meet basic licensure standards. … And it requires all home care aides … to be certified.”
The bill also would publish the names of workers and their occupational data on a public website, a feature that raises privacy concerns for Jennifer Gabales, director of policy, advocacy and public affairs for CAHSAH, the California Association for Health Services at Home.
Study: Insurers Are Palliative Care Innovators
Six major health insurers in California are expanding access to palliative care by providing more specialized case management and opening up the hospice benefit beyond its Medicare boundaries, according to a new study expected to be released today.
The study, “A Better Benefit: Health Plans Try New Approaches to End-of-Life Care,” is accompanied by a second paper in today’s scheduled release: “End-of-Life Care in California: You Don’t Always Get What You Want.” The two papers are funded and published by the California HealthCare Foundation, which publishes California Healthline.
The study of the six largest health plans was based on interviews with stakeholders and with health plan directors, as well as reviews of published studies and academic reports, to determine the extent of palliative care alternatives at those plans.
Money to Be Made, Saved with Biosimilars?
A heated fight has developed over legislation to regulate a biotech development that hasn’t yet hit the U.S. market. On Wednesday, the state Senate Committee on Health will take up the topic of biosimilars and the surprisingly robust debate they’ve sparked.
“Legislation like this is a typical brand ploy,” said Brynna Clark, senior director for state affairs at the Generic Pharmaceutical Association, at a Senate Business and Professions committee hearing earlier this month. “It is being pushed by companies who stand to lose $60 billion in patent [expirations]. They don’t have a compelling interest to allow competition to the marketplace.”
That’s the opposition to the bill. Now a proponent:
“Quite frankly, I am shocked at the insensitivity that has been shown to patients during this debate,” said Eve Bukowski, vice president for state government affairs at the California Healthcare Institute, a not-for-profit research and advocacy organization. For cancer patients like Bukowski, who might need biosimilars treatment and who want their physician to be informed about a change in medication, she said, “Are our opponents really suggesting this is too much to ask? … Really?”