Latest California Healthline Stories
Step Forward for Oral Chemotherapy Bill
The Assembly Committee on Health approved a bill Tuesday that would require health insurers to provide oral chemotherapy therapy to their members with a maximum out-of-pocket $100 co-pay per prescription. Another version of AB 219 by Assembly member Henry Perea (D-Fresno) passed the Legislature last year, but was vetoed by the governor.
“This bill would ensure cancer patients have affordable access to the most appropriate cancer treatment covered by insurers,” Perea said. “When the governor vetoed a similar bill last year, he encouraged me to work with his administration to design a policy that will work for California. AB 219 represents a new strategy to make oral chemotherapy affordable.”
According to Perea, even a fully insured patient can spend $5,000 a month on oral chemotherapy medication, while intravenous treatments are covered by a small co-pay, no matter what the drug costs. So he wants to spread the cost over the entire insured population.
The Assembly Budget Subcommittee on Health and Human Services yesterday approved the settlement over cuts to In-Home Supportive Services. The agreement reduces the severity of the cut from the original 20% proposal to its current 8% cutback.
“While we don’t celebrate any cuts,” said Frank Mecca, executive director of the County Welfare Directors Association of California, “we are in favor of the settlement agreement.”
“Eight is better than 20,” said Holly Mitchell (D-Los Angeles), chair of the subcommittee.
Assembly Bill Would Keep Adult Day Program Going
It was a watershed moment for state officials and senior health advocates in March, 2012 when California launched the Community Based Adult Services (CBAS) program, borne of a lawsuit settlement. It was an effort that calmed political waters and dealt with the 35,000 frail and elderly Californians who had been part of the eliminated program for adult day health services.
Yesterday, the Assembly Committee on Health took up the subject again, in the form of AB 518 by Assembly member Mariko Yamada (D-Davis).
The bill would codify the CBAS program, ensuring that it cannot be dropped when state health officials eventually renew the federal waiver that spawned it.
Physician Assistant Bill Clears First Hurdle
The Senate Committee on Business and Professions approved SB 352 by Sen. Fran Pavley (D-Agoura Hills), a bill designed to allow physician assistants and other providers to oversee work by medical assistants.
“MA’s are only allowed to do basic medical tasks, but if a physician’s not there on-site, then the MA can only do clerical work,” Pavley said. “Under this bill, a nurse practitioner, midwife or physician assistant can supervise them, without a physician being on the premises.”
Pavley made it a point to say the bill doesn’t change what medical assistants are allowed to do, or even what physician assistants or nurse practitioners are allowed to do.
Groups Calling for Pause in Transition
Children’s advocates last week called for a pause in the transition of kids from the Healthy Families program to Medi-Cal managed care. At a legislative hearing Thursday, advocates said the state had promised a relatively seamless transition of 860,000 children to managed care, but that gaps in coverage have already occurred — with the more-difficult phases of the transition yet to come.
The outcry was prompted, in part, when the families of an estimated 207 children who were receiving autism services through the Healthy Families program recently were told their coverage had to be stopped because of the state’s Healthy Families transition.
“From the beginning, we’ve heard assurances that there would be no loss in coverage for children, but we’re seeing it now,” said Serena Kirk, senior policy associate at Children’s Defense Fund California. She said the state’s monitoring effort isn’t working as well as it should be because it didn’t deal with the problems of these 200 families until they’d already been refused services.
Healthy Families Savings Goes from $13M to $137K
At a legislative hearing yesterday, state officials said the estimates for savings have been reduced for the Healthy Families transition to Medi-Cal managed care.
According to the Legislative Analyst’s Office, the original estimated general fund savings for the Healthy Families transition was $13.1 million in 2012-13. The estimate has shrunk to $137,000. Savings for next fiscal year — 2013-14 — were estimated at $52 million and that estimate has been revised to $43 million.
Scott Ogus, who represented the Department of Finance at yesterday’s hearing, said there were several factors contributing to the revision. Delays in implementation by the Department of Health Care Services led to caseload changes. DHCS officials have said the department slowed down some of the early phases of the transition so children would have less disruption in continuity of care.
Five Bills Pass Health Committee
The state Senate Committee on Health yesterday approved two bills designed to help alleviate California’s shortage of physicians and nurses in underserved parts of the state.
The committee also approved three other bills.
The provider bills, SB 20 and SB 271 both authored by Sen. Ed Hernandez (D-West Covina), sailed through the health committee on 9-0 votes.
Public Involvement in Managed Care Licensing?
Thirteen bills came before the Assembly Committee on Health yesterday and all 13 were approved, but not all them got a red-carpet reception.
One of the bills that stirred up opposition from health plans was a proposal by Assembly member Roger Dickinson (D-Sacramento) to open the managed care licensing process to public scrutiny and input.
“We know that millions more Californians will attain coverage under the Affordable Care Act, along with millions more in the impending Medi-Cal expansion, and [the effort] to move current enrollees in Healthy Families and other programs into Medi-Cal managed care,” Dickinson said, “making it an opportune time to apply for managed care licensure.”
Spring Recess Gives Way to Spring Work
The California Legislature yesterday returned to work after a 10-day spring recess. A small mountain of bills is in front of lawmakers who have until May 31 to pass bills off the floor.
Health care legislation up for discussion includes:
Mobile App Highlights Patient Advocate Site
Ratings of health plans’ performance put together by the state Office of the Patient Advocate and newly displayed on its website are now accessible by mobile application.
“This is the first app of this type nationally,” said OPA director Amy Krause. “We hope this makes quality an important part of every doctor visit.”
At the heart of what makes the mobile app worthwhile, Krause said, is the rating system itself, which is based on information provided by the Department of Insurance. Patients can compare performance and quality factors among HMOs, PPOs and medical groups in California, both overall and within specific categories, such as how plans’ providers handle diabetes prevention and treatment.