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

NY Times: Medicare and Medicaid at 50

By THE EDITORIAL BOARD Medicare and Medicaid, the two mainstays of government health insurance, turn 50 this month, having made it possible for most Americans in poverty and old age to get medical care. While the Affordable Care Act fills the gap for people who don’t qualify for help from those two programs, there are … 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

The Sacramento Bee: California’s Medi-Cal program for poor grows to 12 million

BY JUDY LIN SACRAMENTO, CALIF. Since California embraced the federal health care overhaul, the state’s Medicaid program for the poor has added more than 2.7 million people, a surprisingly high number that has left the state to grapple with making sure there are enough doctors to care for all of them. Medi-Cal, the $95 billion … Continue reading

California Healthline: Judge Rules on Medi-Cal Backlog Suit, Orders State To Adhere to 45-Day Deadline

by David Gorn On Thursday, an Alameda County Superior Court judge issued a preliminary injunction requiring the state to adhere to a 45-day limit for processing Medi-Cal applications. The ruling by Judge Evelio Grillo was a victory for health care advocates in a lawsuit over the state’s extensive backlog in processing Medi-Cal applications. The Medi-Cal expansion … Continue reading

Modern Healthcare: Medicaid pay bump helps beneficiaries get appointments

By Virgil Dickson   Increased Medicaid reimbursement for primary-care services to match Medicare rates led to an increased appointments for Medicaid patients, a new study finds. But those care access gains could be wiped out this year because the Patient Protection and Affordable Care Act’s provision authorizing the bump expired Dec. 31, 2014, according to a … Continue reading

The Hill: Medicaid expansion is next top healthcare challenge, advocates say

By Sarah Ferris  Medicaid expansion in two dozen states remains one of the biggest hurdles to guaranteeing healthcare coverage after the rollout of ObamaCare, according to a new report from Families USA. Unless the remaining 23 states opt to expand the eligibility for the low-income insurance program, millions of people will continue to lack affordable … Continue reading

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