Medi-Cal is California’s Medicaid program — a public health
insurance program that provides needed health care services for
low-income families with children, seniors, people with
disabilities, foster caregivers, pregnant women and low-income
people with specific diseases, such as tuberculosis, breast
cancer or HIV/AIDS. Medi-Cal is financed equally by the state and
CHA’s analysis of the impact of pending cuts to reimbursement
rates for hospital-based skilled-nursing facilities and other
providers reveals that as many as 36,000 jobs could be lost
statewide if the cuts go through as planned. CHA’s recently
released report, The Economic Consequences of Hospital-Based
Skilled Nursing Facility Medi-Cal Cuts, found that the
overall ripple effect stemming from the cuts could result in a $2
billion erosion to the state’s economy.
“Planned retroactive reimbursement cuts to Medi-Cal will have a
devastating impact from a health care perspective,” the report
states. “But the consequences go far beyond the nuts and bolts of
health care services. These cuts will also be a massive job
killer with a statewide economic aftershock.”
As part of its comprehensive strategy to highlight the
impact of rate cuts to services provided by distinct-part
skilled-nursing facilities (DP/SNF), CHA has developed and
distributed a media toolkit to DP/SNF member facilities. The
toolkit contains an advocacy handout, fact sheet and FAQs as well
as templates that can be customized, including a support letter,
newsletter article and letter to the editor. Designed to help
members participate in grassroots advocacy that engages community
and opinion leaders and raises public awareness of the
devastating impact of the cuts, the toolkit is part of a broad
CHA campaign to build legislative support for AB 900 (Alejo,
D-Salinas) and SB 640 (Lara, D-Bell Gardens).
CHA has produced several videos
featuring member distinct-part skilled-nursing facilities
(DP/SNFs) and the impact of pending cuts to reimbursement rates.
Featuring patients and families — as well as employees,
physicians and others — the videos were developed to illustrate
the real-life impact of the cuts, which will lead to
reimbursement reductions of 25 percent or more.
The Centers for Medicare & Medicaid Services (CMS) will host a conference call March 28 at 1:30 p.m. (PT) to update Region IX health care associations, physicians and providers on a variety of CMS initiatives. Discussion topics will include:
Health insurance marketplace update (David Sayen, Regional Administrator)
PQRS/value-based modifier reporting requirements (Betsy Thompson, MD, Dr.PH, Chief Medical Officer, Region IX)
Medicare program updates (Division of Financial Management & Fee-for-Service Operations)
The conference call presents an opportunity for participants to ask questions and inform CMS of any concerns about the initiatives. To request that CMS include other topics for discussion, contact Neal Logue at (415) 744-3551 or Neal.Logue@cms.hhs.gov.
The Medicaid and CHIP Payment and Access Commission (MACPAC)
released its annual report to Congress last week. Summarizing its
recent work on issues facing dual eligibles, the commission’s
analysis confirmed that a small number of enrollees with
substantial needs for long-term services and supports drive
Medicaid spending for dual eligibles, demonstrating the need for
reforms targeted to specific subgroups. The report also includes
analysis of the role of state policies for Medicaid payment of
Medicare premiums and cost-sharing for inpatient and outpatient
hospital, skilled-nursing facility, and physician services.
Finally, the commission examined states integrating care under
programs such as Medicare Advantage dual eligible special needs
plans (D-SNPs) and Program of All-inclusive Care for the Elderly
(PACE) plans, and provided an overview of capitated rate setting
in Medicaid managed care.
CHA has announced a
comprehensive public advocacy campaign to highlight the real
life impact of pending rate cuts to services provided
by distinct-part skilled-nursing facilities. The campaign
will engage community and opinion leaders in grassroots advocacy
to raise public awareness of the devastating effect the cuts will
have and to build legislative support for CHA-sponsored AB 900
(Alejo, D-Salinas), which will halt implementation.
The California Legislative Analyst’s Office (LAO) recently
issued a set of recommendations related to the state’s
Coordinated Care Initiative (CCI) project. Authorized by the
Legislature last year, the CCI is an eight-county pilot project
to transition dually eligible individuals into managed care and
integrate long-term care services and supports.
Beginning Jan. 8, The Department of Health Care Services’ Fiscal
Intermediary, Xerox, will host a series of health care provider
training webinars every Tuesday, Wednesday and Thursday from 10
a.m. – 2 p.m. throughout the month. Participants will be able to
print class material before each session and ask questions during
the webinar. The training schedule is attached and webinars
are accessible through the Medi-Cal Learning
Portal or by visiting the home page of the Medi-Cal website.
The Department of Health and Human Services (HHS) has released
its final rule reforming the Medicare and Medicaid Conditions of
Participation for hospitals and Critical Access Hospitals (CAHs).
Among other changes, the final rule increases flexibility for
hospitals by allowing one governing body to oversee multiple
hospitals in a single health system. The rule also allows CAHs to
partner with other providers so they can be more efficient and
ensure the safe and timely delivery of care to their patients. In
addition, the rule allows hospitals and their medical staff to
include non-physician practitioners on the medical staff. CHA is
reviewing the final rule and will release a detailed summary in
the coming weeks. The final rule is attached.
The Department of Health Care Services (DHCS) has revised and
published a document outlining the state’s concept for a Medi-Cal
waiver that would go into effect Sept. 1, replacing the state’s
current waiver for hospital financing and uninsured care that
expires Aug. 31.
The AIDS Healthcare Foundation (AHF) filed a complaint this week
against the Department of Health Care Services (DHCS), seeking an
injunction to prevent the implementation of the new state law
aimed at 340B providers.
More than 300 hospitals enrolled in Medi-Cal have received a
letter from the California Department of Public Health (CDPH) to
secure provider agreements or updates from hospitals. The
targeted mailing was in response to a recent finding in the
single state audit indicating that CDPH did not have complete
provider information on file. The provider agreement is a
requirement of federal and state laws for participation as a
provider in the Medi-Cal program.