Latest Morning Briefing Stories
Legislature Approves Waiver Bills for Medi-Cal
Flying under the budget radar this week were two bills that frame a major restructuring of the Medi-Cal system in California.
The two bills represent about $10 billion in federal dollars coming to California. The waiver is actually negotiated between state and federal officials, and that negotiation is ongoing and due to be wrapped up by the end of this month.
But an official stamp of approval from the Legislature is an important step to eliminate confusion and ambiguity over the new ways Medi-Cal will run, and to limit lawsuits over wording in those new Medi-Cal rules.
Since the start of the reform debate, questions have swirled about Medicaid’s role and sustainability. New reports raise further concerns about the program’s long-term prognosis.
Waiver, Medical Home Bills Linger on Agenda
The Legislature, expected to reconvene soon to pass the budget, will also deal with some legislative leftovers.
Two bills relating to the Medicaid waiver are expected to be approved in both houses.
The fate of a another bill dealing with medical homes is harder to predict.
State Officials Anxious for Word on Medicaid Waiver
At the bimonthly stakeholders’ meeting for the Medicaid waiver yesterday, all eyes turned to the front of the room, where David Maxwell-Jolly was about to speak.
Maxwell-Jolly is the director of the state Department of Health Care Services, and he had just been asked about the status of negotiations with CMS over California’s $10 billion Medicaid waiver. The state, facing a deadline of Oct. 31 to come to final agreement on the waiver, is stuck in idle until the federal agency comes up with a draft of what it likes and doesn’t like about California’s plan.
“We don’t have a draft at this point.” Maxwell-Jolly said. “Any day now, we should be getting it.”
HHS Secretary Sebelius Adopts Initial Enrollment Recs
On Friday, HHS Secretary Kathleen Sebelius accepted initial recommendations, developed by the Health IT Standards and Policy committees’ enrollment work group, that aim to improve the enrollment process for health and human services programs.
It May Be Arcane, But It’s Also Vital
Almost everyone in the health care world knows how important the Medicaid waiver is to California — and really, to the nation.
As the first state to implement national health reform ideals on such a large scale, what happens in California by Oct. 31 with the $10 billion waiver is something that will affect how health care reform is put in place in many other states.
But not everyone in the health care world understands all of the complex give-and-take involved in so many rule changes and manipulations of the health care market.
Medicaid Waiver Big, Innovative and Worth $10 Billion
California officials hope a new agreement being negotiated now with CMS will result in about $2 billion a year in federal money for Medi-Cal over the next five years — roughly doubling the current federal contribution. They’re redesigning Medi-Cal with the aim of establishing an innovative, state-of-the-art managed health care system.
Little Concern About Waiver Timing
When the state Assembly and Senate gather to vote on a budget for California — whenever that may be — members will also vote on the $10 billion Medicaid waiver.
The Medicaid waiver is the plan California has laid out in months of negotiations with CMS to implement the revised Medi-Cal program in California, and to prepare the state for health care reform.
Since California is ahead of the national curve on getting set for the health care reform law, many other states are watching what happens here — which puts additional pressure on federal approval of this large and innovative waiver plan.
Medicaid Waiver Bills Still in Play at Capitol
The legislative deadline passed more than week ago, but at least two health care bills are still at play in the Legislature.
Not only are two bills dealing with Medi-Cal waiver certain to get a vote when the legislature reconvenes to take up the budget, the legislation has several big factors in favor of its passage, according to health care expert Peter Harbage of Harbage Consulting.
“At the end of the day, the policy changes in the waiver and its funding are too valuable for California to pass up.”
Doc Shortage Made Worse by Low Participation in Medi-Cal
California faces two related problems about to get worse: not enough family practice physicians and not enough physicians treating Medi-Cal patients. We asked stakeholders how California should deal with these two shortages.