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Friday, April 17, 2015

Legislative Committee Hearings

Next week, several bills of interest to the Catholic health ministry will be heard.  In addition to the policy committee hearings, there also will be an Assembly Budget Subcommittee that will focus on Medi-Cal provider rates.

Medi-Cal Provider Rates

Assembly Budget Subcommittee 1 on Health and Human Services. On Monday, April 20, this hearing will provide an overview of the Department of Health Care Services, including a discussion of Medi-Cal Rates. The "We Care for California" coalition will be present to testify and present their case for increased Medi-Cal provider rates.

AB 1396 (Bonta). On Tuesday, April 21, the Assembly Health will hear Chairman Bonta’s bill to apply the revenue from the proposed increased tobacco tax (SB 591/Pan) to, among other things, provider rates.

SB 243 (Hernandez). On Wednesday, April 22, the Senate Health Committee will be hear Chairman Hernandez’ bill, which is the Senate policy vehicle for Medi-Cal rate increases.  This bill would repeal implementation of prior years’ Medi-Cal rate reductions, which include the 10 percent reduction to Medi-Cal providers and the retroactive amount owed to the state by hospital-based skilled-nursing facilities; increase payment rates for outpatient health care providers to that of Medicare payment levels; increase hospital Medi-Cal fee-for-service rates and require annual increases thereafter; and, requires the state to reimburse Medi-Cal managed care plans at the maximum rates allowed by federal law – increasing rates for health care providers in managed care networks and improving access for Californians. Its companion bill, AB 366 (Bonta) was heard in Assembly Health this week and passed on a vote of 16-0, with three members not voting.  This bill now moves to the Assembly Appropriations Committee.  The Alliance supports both measures.

This run of hearings is well-timed, as the release of the Governor's May Revision of the State Budget is just a few weeks away.  Proponents of the Medi-Cal rate increase bills hope that this series of committee and bill hearings will help build momentum towards support for inclusion of Medi-Cal provide rate increases in the budget bill.

Other Bill Hearings

AB 1046 (Dababneh). The California Hospital Association (CHA)-sponsored measure to conform most state community benefit reporting with federal post-ACA requirements will not be heard in the Assembly Health Committee on Tuesday, April 21, as was reported last week.  
CHA reports that discussions are underway regarding possible additional amendments.  However, SB 346 (Wieckowski), the competing measure sponsored by the California Nurses Association, which would rewrite and expand existing community benefit requirements and create very onerous charity care and other requirements, will be heard in the Senate Health Committee next Wednesday, April 22.   The Alliance supports AB 1046 and opposes SB 346.

SB 323 (Hernandez). This bill will be heard in the Senate Business, Professions and Economic Development Committee on April 20, this bill would allow nurse practitioners to practice independent of physician supervision.  With the enormous influx of newly-insured Californians, there is great concern about the future of California’s health care provider workforce.  California already faced provider shortages in many areas, and among many physician specialties.

Friday, April 17, 2015

Permanant "Doc Fix" Passe and Signed into Law

As one of its first orders of business upon their return from Spring Recess, on Tuesday the Senate voted 92-8 to pass the Medicare Access and CHIP Reauthorization Act (H.R. 2), legislation to permanently replace the Medicare physician sustainable growth rate formula. President Obama quickly signed the legislation, as the SGR cut was supposed to be imposed two weeks ago.  Also included in the bill was a two-year reauthorization of the Children's Health Insurance Program (CHIP).  This program, which California used to call Healthy Families, is now an extension of the Medi-Cal program for children in families up to 250% of the federal poverty level.  For the next two years, the federal government will continue paying for CHIP at the ACA-enhanced rate – that is, they are paying for 88% of California's program.

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.

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