05/21/2013
On Friday, HHS' Office of the Inspector General published a final rule allowing state Medicaid fraud units to use federal funding for data mining efforts to find fraudulent billing. OIG predicted that the final rule will save about $72 million from 2014 to 2023. Modern Healthcare, CQ HealthBeat.
05/20/2013
At a news conference last week, two Assembly members -- Henry Perea and Jim Patterson -- and hospital administrators called on Gov. Brown and state lawmakers to stop a retroactive 10% cut to Medi-Cal reimbursements for hospital-based skilled nursing services. Patterson said two bills in the Legislature would allow lawmakers to reverse the "disastrous" cuts approved in 2011. Fresno Bee.
05/17/2013
Primary care physicians who participate in Medicaid still are awaiting a reimbursement increase five months after CMS issued a final rule on the Affordable Care Act provision. The increase was slated to take effect on Jan. 1, but only three states -- Massachusetts, Michigan and Nevada -- have implemented it so far, according to the American Academy of Family Physicians. Although all states have applied to start offering the higher rates, CMS only has approved applications for seven states. Kaiser Health News' "Capsules."
05/16/2013
Democratic lawmakers and patient advocates seek to restore funding for California's health care and safety-net programs. Gov. Brown's revised fiscal year 2013-2014 budget plan does not boost funding for such programs. San Jose Mercury News.
05/16/2013
In an Orange County Register opinion piece, columnist Robert Samuelson writes that a recent Oregon Medicaid study that found no physical health benefits among Medicaid beneficiaries compared with uninsured individuals shows that "health status and insurance are only loosely connected." He adds that the findings suggest that the Medicaid expansion under the Affordable Care Act "may result in more spending and health services but few gains in the public's health." Orange County Register.
05/15/2013
In an Orange County Register opinion piece, Bill Dombrowski -- president of the California Retailers Association -- write that a bill in the state Legislature that would "require larger businesses to pay the state a fine for each employee who is enrolled in the state's Medi-Cal program" does "nothing to reduce rising health care costs." According to Dombrowski, all that the bill does "is assess fines on businesses that are already struggling to meet the [Affordable Care Act's] requirements while recovering from the devastating effects of the recession." Orange County Register.
05/15/2013
Gov. Brown has released his revised fiscal year 2013-2014 spending plan, which is a $1.3 billion reduction from his initial proposal. The new plan anticipates $1.2 billion more in Medi-Cal spending to implement health reform provisions. New York Times et al.
05/14/2013
A Los Angeles Times editorial supports a proposal by Health Access and other not-for-profit groups that would let counties keep funds from sales taxes and vehicle fees while the federal government covers the full cost of the Medi-Cal expansion. Under the plan, counties after three years "would receive a set amount per indigent person they enroll in a HMO-style health care network, with any leftover dollars reverting to the state," the editorial notes. It concludes that the "proposal offers a better approach to public health, while leaving counties free to decide who should be eligible for the benefits," adding, "The state should embrace it." Los Angeles Times.
05/14/2013
Observers wonder how Gov. Brown will use $4.5 billion in extra tax revenue in his revised fiscal year 2013-2014 budget plan. Legislative Democrats say they want to restore certain safety-net programs, but Brown has argued for fiscal discipline. Sacramento Bee, KPCC's "KPCC News."
05/13/2013
Gov. Brown and Democrats disagree over how to expand Medi-Cal and how much indigent care funding should be provided to counties. Compared with Brown, Democrats want to expand Medi-Cal coverage to more residents and reimburse physicians and hospitals at a higher rate. Los Angeles Times.
05/10/2013
In a Sacramento Bee opinion piece, Peter Manzo -- president and CEO of United Ways of California -- argues that accepting federal fund to expand Medi-Cal will "dramatically reduce" the number of uninsured Californians and "ensure" a better use of the state's health care dollars. He writes, "Taking a hard-line approach to financial realities is one thing, but leaving millions of federal dollars on the table -- when we have many Californians without health coverage -- would be not only fiscally irresponsible but heartless." Sacramento Bee.
05/09/2013
On Monday, Department of Health Care Services Director Toby Douglas announced that Cal MediConnect -- a demonstration project intended to better manage care for residents enrolled in both Medi-Cal and Medicare -- will not begin until January 2014 at the earliest. Few details were given as to the cause of the delay. Payers & Providers.
05/07/2013
Last week, a three-judge panel of California's 3rd District Court of Appeal ruled that the state has the authority to limit Medi-Cal payments for federally qualified health clinics to two visits per month for patients seeking psychological services. The ruling overturned a decision by Sacramento Superior Court Judge Michael Kenny, who granted a request by three Northern California clinics seeking payment beyond two of such visits. Sacramento Bee.
05/02/2013
A study published in the New England Journal of Medicine finds that having Medicaid coverage lowers a person's risk of depression and catastrophic medical expenses but does not necessarily result in major health improvements. Los Angeles Times' "Politics Now" et al.
04/25/2013
On Wednesday, a broad-based coalition of groups representing health care providers, health plans and Service Employees International Union held a news conference in Sacramento to pledge its support for SB 640, which would block the implementation of a 10% rate cut to Medi-Cal providers. Later on Wednesday, the Senate Health Committee voted 8-0 to approve the measure. Sacramento Bee's "Capitol Alert."