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California is running out of funds to pay for the Children’s Healthcare Insurance Program — the state usually gets around $2.7 billion a year in federal money, but Congress has yet to renew the funding.
CMS Administrator Seema Verma spoke about changes she wants to see to Medicaid, as well as the lack of providers accepting Medi-Cal and Medicare in Stanislaus and San Joaquin counties due to low reimbursement rates.
While hospice care is already covered by Medi-Cal, palliative care won’t be until next year. Some residents, however, are getting early access through a pilot program.
The Department of Health Care Services will oversee a consultant-led study to look into what other states have done, financing options and other issues.
Efforts to renew the popular program have stalled in Congress.
About 2 million California children get check-ups, vaccinations, emergency visits and other benefits through the popular program. The funding for CHIP has stalled in Congress.
The independent pharmacists say the lower rates were triggered by changes involving the Gold Coast Health Plan, the publicly funded agency that administers Medi-Cal health insurance to more than 200,000 low-income people across Ventura County.
In many cases, Medi-Cal pays doctors just 6 percent more than they were paid in 1985 to treat adult Medi-Cal patients.
Republican efforts to pass a repeal-and-replace plan by Sept. 30 are over, as Senate leaders reverse their plan to hold a vote this week on the Graham-Cassidy bill.
Suing Medicaid is difficult so other civil rights groups are monitoring this case, but experts say similar actions elsewhere could be difficult to win.