Latest Morning Briefing Stories
Friday Is New Deadline for Waiver
State health officials get another few days to fine-tune the complex and multi-faceted Medicaid waiver, a plan that is expected to revamp and expand California’s Medi-Cal program. The waiver is worth about $10 billion in federal money over the next five years.
On Friday, CMS granted the extension in a letter to California’s Department of Health Care Services, saying that the agreement was close to finalization and that the extra few days are necessary to finish the “Bridge to Reform” demonstration.
“With these extra few days, we are confident we can finalize the documentation and provide the State with an approval of the Demonstration,” the extension letter said.
Agreement Expected Today on Medicaid Waiver
The formal deadline for wrapping up negotiations on the federal Medicaid waiver for California is Oct. 31, and state officials say it might go right up to the deadline. But since that deadline is on Sunday, health care policy experts are expecting an agreement to be formalized and announced two days earlier than that — by today.
The Medicaid waiver is a complex and multipronged plan to revise the state’s Medi-Cal program and prepare California to implement national health care reform.
California stands to receive about $2 billion a year in federal money over the next five years in the agreement. Roughly half of that is in new money — money beyond what the federal government currently pays per year to help fund Medi-Cal, California’s Medicaid program.
Exchange Passage Raises Question: Now What?
When you’re the first to launch a new program, it is often greeted with a measure of fear and suspicion, according to Jon Kingsdale, former executive director of the Commonwealth Health Insurance Connector Authority in Massachusetts.
And one of the common misconceptions about the exchange in Massachusetts and the exchange-to-be in California, he said, has been the worry that somehow the exchange will be constantly at odds with health insurance companies.
“As a non-regulatory marketplace for insurance, with a mandate to serve the public, there is a strong interest in having long-term, value-based relations with health plans,” Kingsdale said. “Meaning, we want them to make a little money.”
Preparing for Medi-Cal Transition
State and federal officials are busy finalizing the Medicaid waiver — the agreement on how California should spend $10 billion in federal money on its state Medi-Cal program.
The new way Medi-Cal will run represents a bridge to the full implementation of federal health care reform policies that have to be in place by 2014.
The current negotiation is set to finish at the end of this month.
Dealing with Continual, Constant Cuts
“Well, I have to tell you, I’m looking forward to getting paid again.”
That’s the summary reaction to passage of the state budget from Dave Jones, CEO of Mountain Valleys Health Centers up north in rural Lassen County.
“We are all relieved to have a budget,” he said.
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.