Latest California Healthline Stories
From Supreme Court to Appeals Court
Yesterday’s decision by the U.S. Supreme Court had a ripple effect in California, influencing a number of lawsuits in the state over health care cuts.
Four lawsuits have been filed over the 10% Medi-Cal provider rate cuts, and in all four cases, a federal judge has issued a temporary injunction blocking those cuts. In another court case, an injunction halted 20% trigger cuts to Californians receiving In-Home Supportive Services.
All of those cases were waiting to see what the Supreme Court would decide in Douglas v. Independent Living Center of Southern California. Yesterday’s decision to send that case back to the Ninth Circuit Court of Appeals was a huge victory for patient rights’ groups, according to Melinda Bird, a Disability Rights California attorney.
Can Health Equity Be a Moneymaker?
Sometimes the right thing might also be the financially beneficial thing.
Physician groups are gathering today in Sacramento for a conference on disparities in health care related to race, language and geography. This time, the debate is not just about the moral imperative to promote equity in health care, but also about the clinical and financial impetus to make that move.
“The thing that has changed, as more people are brought into systems of care with accountability, health organizations are going to be looking at avoidable cost as well as avoidable risk,” according to Wells Shoemaker, medical director of the California Association of Physician Groups, which organized the conference.”It’s sort of the low-hanging fruit when you’re looking for avoidable costs.”
Getting a Head Start on Medi-Cal Expansion
For a program no one’s really heard of, this one is pretty successful.
Counties started enrolling people into the Low-Income Health Program in July 2011, and four months later (at the most recent count in November) about 260,000 Californians were enrolled in it, according to Linda Leu, a health care policy analyst with Health Access California.
“It is a really great opportunity for those who are low-income, and who have been left out of programs like Medicaid [or, in California, Medi-Cal],” Leu said.
And with an acronym like LIHP, the perfect time to publicize the program is on Valentine’s Day, she said.
Study: Uninsured Face Similar Debt as Medi-Cal Beneficiaries
More Californians are borrowing money to pay for health care services — and two-thirds of them have medical insurance, according to a new study by the UCLA Center for Health Policy Research.
“When you think you’re insured, you still end up paying a percentage and that adds up, into thousands of dollars,” report author Shana Alex Lavarreda said. “So having insurance doesn’t mean you will have things paid for.”
Another surprising finding, Lavarreda said, is that uninsured Californians face a similar medical debt level to those who have insurance through Medi-Cal.
It May Be Time ‘To Take the Pain’ on Medicaid
New Kaiser Family Foundation data illustrate the rise in Medicaid enrollment and lawmakers’ continuing struggle to control costs. Budget battles in Washington state, not Washington, D.C., may show the future of the program: stark efforts to slow utilization.
Medical Transport Lawsuit Gets Federal Injunction
A federal judge issued a preliminary injunction Wednesday to halt a 10% Medi-Cal provider reimbursement cut to medical transportation services.
It was the third time the state has lost in court on this issue. State officials said the state will appeal. Preliminary injunction rulings at the end of December halted cuts in hospital and pharmacy services. Another lawsuit, brought by the California Medical Association and other providers, is still pending.
Marat Sheynkman, executive director of the California Medical Transportation Association, which filed the suit that triggered Wednesday’s ruling, said the 10% Medi-Cal reimbursement cut would have hit medical transport providers particularly hard.
What’s Best Enrollment Process for Dual Eligibles?
State officials face a key decision in orchestrating a shift into managed care for more than one million Californians who are beneficiaries of both Medicare and Medi-Cal: How to enroll people in the new plans. We asked stakeholders and experts to discuss pros and cons of various enrollment options.
Legislation Would Require On-Time Medicaid Payments
Sarane Baker-Collins remembers the time well. “We went for months without a [Medi-Cal] payment. We kept doing our work, and the state didn’t pay us for months. It’s almost criminal what the state did to us.”
Baker-Collins runs three small homes for residents with developmental disabilities in Santa Rosa. In the wake of the budget impasse of 2008, California had to shut off payments to Baker-Collins and other health care providers until a budget could be agreed upon.
Some Medi-Cal providers went as long as 60 days without reimbursement. For a small not-for-profit on a thin margin like the one run by Baker-Collins, that’s a cost hard to bear.
State Starts Year Facing Multiple Lawsuits, Hearings
California health care officials are fighting a number of lawsuits in courts ranging from the U.S. Supreme Court to federal district courts. The budget crisis in California has prompted drastic cuts in health care services, triggering more than half a dozen legal challenges.
Federal Court Halts Some Medi-Cal Cuts
A federal judge last month blocked California’s plan to cut Medi-Cal provider reimbursement rates to skilled nursing facilities and pharmacies. State officials said they will appeal the decisions.
The two lawsuits were brought by Managed Pharmacy Care and the California Hospital Association.
“We’re pleased by the court decision,” Jan Emerson-Shea of CHA said. “We believe it is the right thing to put the interests of patients first.”