California Healthline: Changes Afoot for Orange County Duals

by David Gorn, California Healthline Sacramento Bureau range County is slated to start enrollment this week in the Cal MediConnect duals demonstration project. The Cal MediConnect demonstration project is designed to enhance care and integrate coordination for duals by combining the financing and services of Medicare and Medi-Cal, California’s Medicaid program. It was launched with … Continue reading

California Healthline: Auditor’s Report Shows ‘Symbiotic Relationship’ in Medi-Cal Managed Care

by David Gorn The seeming reluctance by state officials to closely monitor Medi-Cal managed care plans is troubling, said Gerald Kominski, director of the UCLA Center for Health Policy Research. Reacting to a June report from the California State Auditor’s office that criticized the Department of Health Care Services for lax oversight of Medi-Cal managed care plans, … Continue reading

California Healthline: Supreme Court Ripples in California

The Supreme Court decision on Thursday upholding the legality of federal subsidies in health benefit exchanges in 34 states did not directly pertain to California. This state was one of 16 that established its own exchange, Covered California. But a ruling against the subsidies would have had a tremendous effect on California’s health care reform … Continue reading

California Healthline: Big Day for Health Care Bill Passage

by David Gorn Floor sessions on Tuesday in the state Senate and Assembly were fast-paced affairs. The deadline to pass bills out of their house of origin is June 5 so the legislation queue on Tuesday was pretty long and resulted in a rapid-fire pace. The Senate passed a high-profile measure to expand coverage to some … Continue reading

California Healthline: Protest Rises Over Medi-Cal Rates

by David Gorn The Capitol lawn is going to be a little livelier on Tuesday, as hundreds of protesters from across the state are planning to gather in Sacramento in an effort to boost Medi-Cal provider rates. The state’s budget is due June 15, and a consortium of health advocates and providers want to use … Continue reading

California Healthline: If Calif. Ends Coordinated Care Initiative, What Happens to Frail Senior Duals?

Photo Jay Reiter/MCT via Getty Images

by David Gorn Zelda Gamble of Long Beach, 74, has diabetes, high blood pressure and severe rheumatoid arthritis that keeps her confined to a motorized wheelchair all day. Gamble is one of roughly 12,000 frail seniors across California who depend on the Multipurpose Senior Services Program, or MSSP, for services and care that help them … Continue reading

California Healthline: CMS Settlement May Have Ripple Effect

by David Gorn MS officials this week approved a settlement officially halting a 10% Medi-Cal payment reduction from 2011 at California independent living centers. Federal approval came three years after the issue was settled in court. The state of California settled a series of lawsuits around the independent living centers’ Medi-Cal reductions in 2012, but … Continue reading

California Healthline: If Duals Project Is Curtailed, Future Is Cloudy for Program for Frail Seniors

by David Gorn Some advocates and legislators are urging the state to extend the timeline for transitioning the Multipurpose Senior Services Program into managed care plans within the seven-county duals demonstration project. The duals project, also known as Cal MediConnect, is part of the Coordinated Care Initiative that affects roughly two-thirds of the state’s duals population in seven … Continue reading

California Healthline: State Readies Health Home Project

by David Gorn California health officials expect to release within a week a fleshed-out proposal for a health home project that could reduce state costs and improve the lives of super users of the Medi-Cal health care system. It’s a plan that won’t cost the state anything but has the potential to save quite a … Continue reading

California Healthline: Medicare, ACA Have Faced Similar Criticism. But Is That Where the Comparison Ends?

by Michelle Stuckey, California Healthline Editor As Medicare turns 50, many observers are looking back at the program’s beginning and drawing comparisons with more recent health reform efforts, namely the Affordable Care Act. A recent article in the New England Journal of Medicine on the beginning of Medicare notes that the program started “only after … Continue reading

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