Latest California Healthline Stories
Children’s Programs Slowly Moving Forward at MRMIB
Reports of the demise of the Managed Risk Medical Insurance Board were a little premature. There it was, alive and well at its monthly meeting last week, discussing expansion of existing programs and establishment of new ones.
MRMIB runs four programs: Healthy Families, Access for Infants and Mothers (AIM), the Pre-Existing Condition Insurance Plan (PCIP) and the Major Risk Medical Insurance Program (MRMIP).
The agency was slated for elimination under the governor’s May budget revision. The current plan still is to phase out MRMIB’s activities by 2014, when much of its mission will be taken over by the new federal health care reform law. But when the Gov. Jerry Brown (D) announced in May that he wanted to move 900,000 children from the Healthy Families program to a Medi-Cal managed care plan, Brown also proposed the quick elimination of MRMIB, since Healthy Families is such a large part of what MRMIB does.
Adult Day Health Care Waits for the Governor
First of all, Assembly member Bob Blumenfield (D-Woodland Hills) wants to make it clear there is reason to be hopeful.
“We have had multiple meetings with the governor’s office, making it clear what the legislative intent is,” Blumenfield said. “There is light at the end of the tunnel.”
The Legislature passed Blumenfield’s bill, AB 96, which would set up the Keeping Adults Free from Institutions program, at about half the cost of the previous adult day health care program. If Gov. Jerry Brown (D) signs it this week, $85 million would be spent trying to keep a good number of the 300 ADHC centers across the state open, and could keep thousands of seniors out of nursing homes.
Non-Contracted Services at Heart of Two Court Cases
A woman named Fucino, who is eligible for the County Medically Indigent Services Program (CMISP) and gets her care in Sacramento County, one day traveled to Monterey County to visit family. While in Monterey, she had a health issue that landed her in the emergency department in that county.
Does Sacramento County have to pay for that out-of-county ED visit? And more important, what does all of that have to do with a multimillion-dollar lawsuit filed against the county by UC-Davis?
The answer to the latter question is: non-contracted services. It’s the same principle at the core of both cases, where the court has to decide whether or not the county should pay for non-contracted services.
Is the State Shifting its No-ADHC Stance?
The state has been fighting a long battle to eliminate the adult day health care program in California — including arguing the case to eliminate it this month in district court.
That’s why yesterday’s announcement from the Department of Health Care Services was such a surprise. The department said it would delay the planned Sept. 1 elimination date for ADHC.
“The director [of DHCS] has the authority to extend the ADHC deadline, and that’s what he’s doing,” Tony Cava of DHCS said.
ADHC Lawsuit Gets Federal Support
It’s a little like the Monty Python skit where the guy keeps hopping out of the wheelbarrow during the Black Plague, saying, “I’m not dead yet.”
Well, adult day health care isn’t quite dead yet in California.
The elimination date to end the program is Sept. 1, but a lawsuit to halt that elimination just got a big boost from the federal Department of Justice, which filed an amicus brief in support of the ADHC program.
Federal Officials Take Non-Stance on Rate Regulation
This year, few bills have stirred as much vitriolic rhetoric as the proposed health insurance rate regulation law, AB 52 by Assembly members Mike Feuer (D-Los Angeles) and Jared Huffman (D-San Rafael).
Now the statewide spat threatens to draw in federal officials, and they’re having none of it.
It all revolves around a recent report from HHS, which concluded that California’s current health insurance rate review is “effective.”
Lofty Expansion Plan for Children’s Health Initiative
They’ve added a “C.” But that’s not the only change.
The successful not-for-profit Children’s Health Initiative (CHI) has changed its name and has now become California Coverage & Health Initiatives. The shift is an ambitious one.
“Originally the CHIs were local efforts to reach universal coverage for kids in a county or group of counties,” CCHI executive director Suzie Shupe said. “And we do have a pretty good track record of helping families access care, and keep them retained.”
Food Fight Over Vending Machines
The intent is simple, according to AB 727 author Assembly member Holly Mitchell (D-Los Angeles).
“We would like the food sold in vending machines and cafeterias in state buildings to meet minimum nutritional and sustainability standards,” Mitchell said. “AB 727 will promote a healthier workforce by making healthy food options more acceptable and affordable.”
The Assembly Committee on Health last week approved AB 727, but only after a long, protracted and surprisingly emotional hearing.
Assembly Committee Approves Basic Health Bill
This week, the Assembly Committee on Health approved a bill to establish low-cost health coverage for as many as 800,000 low-income Californians. For a program that could pull a substantial number of expected participants out of the California Health Benefit Exchange, there has been surprisingly little resistance to it.
That’s because the state stands to save money with the new Basic Health Program, according to SB 703 author Sen. Ed Hernandez (D-West Covina).
“With this program, the state can supply more affordable coverage [for low-income beneficiaries] without a dime from the state general fund,” Hernandez said. “And it would reimburse providers at much higher rates than Medi-Cal would pay — about 20% to 25% higher reimbursement rates.”
Caveats, Proposed Amendments Clear Way for Rate Regulation Bill
The bill to regulate health insurers’ rate hikes cleared a key hurdle yesterday, as the Senate Committee on Health voted 5-3, with one abstention, to approve AB 52 by Assembly member Mike Feuer (D-Los Angeles).
Passage came with many caveats and even more proposed amendments. Sen. Ed Hernandez (D-West Covina), the committee chair and the swing vote on the bill, suggested a raft of changes to the bill before it could garner his support.
“Primarily it’s important to depoliticize the decision process [around rate assessments],” Hernandez said. “It’s also very important to insert additional transparency in the process.”