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Let the Health Care Changes Begin

Many of the signed bills from last session of the California Legislature become law this week, such as a network adequacy provision that requires monitoring of timely access for Medi-Cal patients.

The first day of 2015 also ushers in two rate reductions for some Medi-Cal providers:

  • The two-year federal increase in primary care provider rates ended Jan. 1. Medi-Cal primary care providers were reimbursed at higher Medicare levels in 2012 and 2013. Those rates return to usual Medi-Cal levels this week.
  • The 10% Medi-Cal provider rate reduction approved by the state Legislature in 2011 officially went into effect among primary care providers Jan. 1. It’s the last phase in implementation of that reduction.

Among the health care bills becoming law this week in California:  

  • SB 964 by Sen. Ed Hernandez (D-West Covina) puts a system in place to ensure greater network adequacy for patients — in particular for Medi-Cal managed care enrollees. The Department of Managed Health Care now must conduct annual reviews to ensure proper access to care and adequacy of health plan networks. That includes patients enrolled in Medi-Cal managed care plans, where a number of questions from consumer groups have been raised about network adequacy.
  • AB 1962 by Assembly member Nancy Skinner (D-Berkeley) requires dental-only health plans to follow the same medical loss ratios as other health plans.
  • SB 912 by Sen. Holly Mitchell (D-Los Angeles) extends a current requirement to make sure vending machines in state buildings contain about one-third healthful foods. The law is a compromise from Mitchell’s original pursuit of a 50% requirement.
  • SB 1446 by Sen. Mark DeSaulnier (D-Concord) allows an extra year for small business owners with grandfathered health insurance policies to make the transition to ones that comply with the Affordable Care Act.

Related Topics

Capitol Desk Medi-Cal