Latest California Healthline Stories
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.”
How To Protect Seniors During Duals Conversion?
Yesterday’s stakeholder meeting to help plan the duals conversion pilots was partially notable for what it was not.
It was not rancorous, it was not loud and the discussion went relatively smoothly for the Department of Health Care Services, compared with last week’s grilling of DHCS over the smaller conversion of SPDs (seniors and persons with disabilities) to managed care.
“Hearing the issues here today is very important for us,” Melanie Bella of CMS said at the end of the meeting. “A couple of things we said were non-negotiable here are stakeholder involvement, meaningful stakeholder involvement and consumer protections.”
Clashing Views of Transition for Seniors, Disabled
Either the state’s transition to managed care is going great, or it’s a confusing mess.
That would depend on who’s talking. At a joint oversight hearing last week, convened by the Senate and the Assembly committees on health, government officials outlined a generally positive picture for the effort to move Medi-Cal seniors and people with disabilities (SPDs) from Medi-Cal fee-for-service to managed care.
“The transition of seniors and people with disabilities into managed care is part of the triple mandate from [the federal] HHS,” according to Jane Ogle, deputy director at the Department of Health Care Services. “Better health, better quality and more cost-effective care.”