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Friday, March 16, 2015

SB 128: Assisted Suicide Hearing

Next Wednesday, March 25 at 1:30 pm, the Senate Health Committee will hold the first policy committee hearing on SB 128 (Wolk-Monning), the “End of Life Options Act” that would legalize assisted suicide.  In anticipation that this will be a highly emotional, well-attended hearing with media coverage, this bill will be a Special Order of Business, meaning that it will be heard before all other legislation on the agenda.

The Alliance is working with its health system advocacy leaders, as well as our coalition partners, to urge members of the Senate Health Committee to vote “no” on this measure.  The opposition coalition includes physicians, many disability rights organizations and other faith-based groups.

For those unable to attend the hearing in Sacramento, a live webcast will be available at:

Friday, March 16, 2015

Low Medi-Cal Reimbursement Rates Scrutinized

On Thursday, Subcommittee #3 of the Senate Budget and Fiscal Review considered budget matters related to the Department of Managed Health Care and the Department of Health Care Services.  The adequacy of Medi-Cal reimbursement rates to assure access to care was again a topic of much interest to legislators. While the Subcommittee took not votes on AB 97 rate restorations or rate increases, bi-partisan concern was again voiced over the need for adequate reimbursement rates to assure that health providers would be available to provide care to the state’s growing number of Medi-Cal beneficiaries.

Friday, March 13, 2015

Physician Assisted Suicide Set for Hearing

As already reported, SB 128 (Wolk-Monning) is scheduled for hearing by the Senate Health Committee on Wednesday, March 25 at 1:30 pm in Room 4203 of the State Capitol.  The Committee announced that the bill would be a “Special Order” which means that it will be the first bill taken up when the Committee convenes at 1:30 pm.  The Alliance is working with its health system advocacy leaders to contact key Senate members urging their “no” vote on SB 128.

Friday, March 13, 2015

AG Proposes Modifications to Nonprofit Hospital Transaction Regulations

This week, the Office of the state’s Attorney General (AG) provided notice of modifications to the 2014 proposed amendments to regulations governing nonprofit hospital transactions. As you will recall, last year the AG issued a Notice of Proposed Rulemaking that proposed to amend the regulations governing the AG’s review and approval of nonprofit hospital transactions.  This was on a parallel track with last session’s SB 1094 (Lara) – that was ultimately vetoed by Governor Brown.  The original amended regulations greatly expanded the AG’s existing authority giving the AG almost unlimited power to change the conditions agreed to by the parties in a hospital transaction, after the acquisition of the facility was completed.  The original amendments to the regulation also proposed a specific section on reproductive health care services reporting and data requirements.  The Alliance is in the process of fully reviewing the most recent proposed modifications to the regulations. It appears that the AG has removed some of the more onerous enforcement provisions that were proposed both in the 2014 amendments, as well as those that appeared in SB 1094.  However, new language has been included that may cause significant concern. There was some change to the reproductive services section; however, it retains the additional disclosure/scrutiny on reproductive health services.   The AG has given a very brief review period – comments are due March 27.

Friday, March 13, 2015

Department of Health Care Services (DHCS) to Host 1115 Waiver Webinar

DHCS will host a webinar to give stakeholders a walkthrough of the Section 1115 Waiver Renewal application.  The Department reports that its waiver renewal application is comprised of three core components:  (1) shared savings with the federal government to be reinvested into the Medi-Cal program; (2) a set of delivery system transformation and alignment programs; and (3) a redesign of reimbursement methods for our public hospital systems that is tied to providing care for the remaining uninsured.  DHCS says that the application will be submitted to the Centers for Medicare & Medicaid Services (CMS) for consideration at the end of March.  The DHCS webinar is scheduled for March 18, 2015, at 4 p.m.  You can register at

Friday, March, 6, 2015

Joint Hearing on Medi-Cal Rates

On Wednesday, the Senate and Assembly Health Committees held a joint hearing titled “Do Medi-Cal Rates Ensure Access to Care?”  The opening and closing remarks of the hearing were provided by Jennifer Kent, the newly-named director of the Department of Health Care Services (DHCS), and Mari Cantwell, the Chief Deputy Director of DHCS.  Both talked broadly about the fact that the Medi-Cal program is 80 percent managed care, and the managed care plans are subject to Knox-Keene and Timely Access standards.  Due to those standards, DHCS alleges, managed care plans pay substantially above fee-for-service rates. They also noted that a number of providers had “stepped up” to help improve Medi-Cal reimbursements while benefiting the state General Fund through provider fees and the provision of match to secure additional federal funds.

The Department faced very skeptical questions from the members of the two committees, especially Senator Richard Pan, MD (D-Sacramento) and Assemblymember Jim Wood, DDS (D-Santa Rosa).  Drs. Pan and Wood are two of the four members of the legislature who were previously health care practitioners.  Also of note, the skepticism of the Department came from members of both parties, with Senator Janet Nguyen (R-Orange County) and Assemblymember Marie Waldron (R-San Diego) asking some of the toughest questions.

After the DHCS opening remarks, there were two reactor panels: one with the LAO and the State Auditor, and one with health plans and providers.  The State Auditor is currently engaged in an audit to look at the accuracy of published networks for Medi-Cal managed care plans.  On the provider panel, Shelly Schlenker of Dignity Health, representing the California Hospital Association (CHA) and hospitals, and Luther Cobb, MD, the President of the California Medical Association (CMA), talked about how underfunding of Medi-Cal hurts patient access to care.  They both spoke of the need to reverse the AB 97 cuts and increase Medi-Cal rates going forward.

To view the hearing or see the full agenda, go to:

Prior to the hearing, Senator Hernandez and Assemblymember Bonta held a joint press conference along with representatives of We Care for California, a coalition including CHA, CMA, Dignity Health and SEIU.  The press conference announced AB 366 (Bonta) and SB 243 (Hernandez), two bills aimed at reversing the AB 97 cuts.

Friday, February 13, 2015

Legislative Deadlines

Two more weeks remain before the legislative deadline, February 27, for new bills to be introduced.  We expect bill hearings to begin in earnest in mid to late March. Both the Assembly and Senate Health Committees are planning to hold informational hearings, which they reportedly want to conclude before hearing bills. A little over 575 bills have been introduced to date.  A typical session has close to 2000 new bills introduced.

Latest News on Assisted Suicide

California Lawsuit:
On Wednesday, Kathryn Tucker, formerly with Compassion & Choices and now with the Disability Rights Legal Center (DRLC), filed a lawsuit in San Francisco Superior Court asking the court to declare that physicians who provide a lethal prescription for medication to a mentally competent terminally ill patient for the purpose of hastening their death should not be subject to criminal prosecution under existing California law. Penal Code Section 401 currently provides “that every person who deliberately aids or advises, or encourages another to commit suicide, is guilty of a felony.”  The lawsuit argues that the choice of such a dying patient is not "suicide," nor is the physician assisting such a patient in "committing suicide."  Additionally, the case argues that patients facing the end of their lives have a right under the California State Constitution to make autonomous decisions about their bodies and how they will die. Tucker also filed a similar case in New York last week.  The plaintiffs in the California lawsuit include a cancer patient and five physicians, two of whom have cancer.

Colorado Bill Defeated: Last Friday, Colorado’s newly-introduced assisted suicide bill was rejected by the Public Health and Human Services Committee in the state’s House of Representatives on a 9-to-4 bipartisan vote.  According to Compassion & Choices, there is “legislative action” in 21 states and Washington, DC.  Colorado is the first of, what is hoped to be, many defeats this year.

Friday, February 6, 2015

Informational Hearing on Health Care Costs

On Wednesday, the Senate Health Committee held one of the first hearings of the new legislative session. This informational hearing – "Making Health Care Affordable: What's Driving Costs?” – generally explored the drivers of health care costs, focusing on hospital and drug costs specifically. The committee heard from three panels: payers (including the Department of Health Care Services, CalPERS, labor organizations and health plans); the biomedical industry; and, health care providers (including the California Hospital Association).  The California Health Care Foundation (CHCF) wrapped up the remarks with their perspective on potential remedies.   A main focus of the hearing was the cost of specialty drugs, such as the $1,000 drug used to treat Hepatitis C.  However, drug prices were just one of the many areas that were scrutinized.  Speakers said that physician fees and hospital facility fees are also a major factor with consumers be asked to shoulder more out of pocket costs for their care. In public comment patient groups voiced disapproval that they were not invited to offer their perspective.   It should be noted that Senator Hernandez, chair of the Senate Health Committee, is the author of SB 26 to create the "California Health Care Cost and Quality Database," known as the All-Payer Claims Database (APCD), a concept which has been promoted by CHCF. The APCD concept is specifically mentioned in the committee background paper for the hearing that, along with other committee background documents, can found at:

Friday, February 6, 2015

Assited Suicide Double Referred

SB 128 (Wolk-Monning): Physician Assisted Suicide.
While no hearing dates have yet been set, the measure has been double referred to the Senate Health and Judiciary Committees by the Senate Rules Committee.

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