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 https://attendee.gotowebinar.com/register/1630039547356620290
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: http://calchannel.granicus.com/MediaPlayer.php?view_id=7&clip_id=2597.
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.