Medi-Cal

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On Medi-Cal Now, Lose Your House Later?

(Erik Soderstrom via Flickr)

(Erik Soderstrom via Flickr)

Catherine Jarett ran into a nasty surprise after she sent a form to Medi-Cal on behalf of her clients. An estate attorney, Jarett was hired by the sons of an elderly Vallejo woman who had died. The woman had been enrolled in Medi-Cal, the state’s insurance program for the poor, for more than 20 years.

Many on Medi-Cal learning that the state can file a claim against their estate after they die.

After Jarett filed the form with Medi-Cal — a death notice as required — the state sent a bill for a hefty $76,349. Jarett was stunned. It was for the cost of “health insurance, vision insurance, dental insurance,” she said.

The bill was part of Medi-Cal’s “estate recovery program.” Under a federal law not widely known to consumers, states can seize assets of Medi-Cal beneficiaries after they die. “I was never aware of this wrinkle that they could recover for health insurance,” Jarett said. Continue reading

Millions Need to Be On Alert for Medi-Cal Renewal

(Screen shot of California's Department of Health Care Services website)

(Screen shot of California’s Department of Health Care Services website)

By Emily Bazar, CHCF Center for Health Reporting

I spend the majority of my time (and space) writing about the new state health insurance exchange, Covered California.

But the behemoth in California’s Affordable Care Act implementation is Medi-Cal, the state’s decades-old version of the federal Medicaid program, which provides publicly funded insurance to low-income residents.

About 12 million Californians are in Medi-Cal now. That’s roughly one in three state residents. By comparison, about 1.4 million Californians are enrolled in Covered California.

Given its size, Medi-Cal’s annual renewal process is now one of its greatest challenges. Continue reading

Majority of Medi-Cal Kids Not Getting Regular Dental Care

Dentist and child

(Photo: Herald Post/Flickr)

by David Gorn, California Healthline

A joint legislative hearing scheduled for Tuesday in Sacramento will examine a state auditor’s report that found more than half the children in California’s Medicaid dental program are not getting regular dental care and the number of dental providers in the program is dropping.

“What the audit makes clear is that we could be doing a better job in California. More than half of the children [in the Denti-Cal program] are not getting the care they need,” said Jacob Vigil, legislative advocate for Children’s Partnership, a children’s health advocacy organization.

“There is a huge issue of access here,” said Vigil, who is scheduled to testify at today’s hearing. “This audit is unique in the way it comprehensively lays out the problem, outlining the kind of recommendations that could make a difference. It represents a significant moment.” Continue reading

Uninsured Rate for Latino Students Down Sharply at State Universities

Covered California enrollment fair in Pasadena, CA in Nov. 2013. (David McNew/Getty Images)

Covered California enrollment fair in Pasadena, Nov. 2013. (David McNew/Getty Images)

By David Gorn, California Healthline

The rate of uninsured students at two California State University campuses dropped dramatically overall, and Latino students in particular saw a steep decline, according to poll results released Wednesday.

At Cal State LA, the Latino uninsured rate dropped by 75 percent since 2013.

Seven CSU campuses now have an estimated 7 percent overall rate of uninsured students, according to Walter Zelman, director of the CSU Health Insurance Education Project, which works to sign up uninsured students.

This is a population — the so-called “young invincibles” — that traditionally has high rates of the uninsured. Zelman pointed out they also happen to be the healthy, lower-cost enrollees that health insurance plans and Covered California would love to have in their patient mix. Continue reading

Pressure Rising to Restore Medi-Cal Provider Rates

FILE PHOTO: Doctors in an emergency room in Panorama City, Calif. (David McNew/Getty Images)

FILE PHOTO: Doctors in an emergency room in Panorama City, Calif. (David McNew/Getty Images)

By David Gorn, California Healthline

A protest Wednesday at the Capitol Building will highlight proposed legislation to reverse cuts to Medi-Cal provider rates.

In 2011 during a bleak budgeting period, the Legislature agreed to cut most Medi-Cal provider payments by 10 percent. The cutbacks were held up in legal battles for two years, and the court eventually sided with the state. Implementation came from the state in stages, and primary care providers started getting the lower reimbursement rate this year, on Jan. 1.

Last month, Assembly member Rob Bonta (D-Alameda), who chairs the Assembly Committee on Health, introduced a bill — AB366 — to reverse the cuts made in 2011.

Protest at Capitol Building aims to reverse cuts.

“This is my top priority,” Bonta said. “The reason I’m interested in health policy is to maximize quality care and access for as many people as possible. And access within Medi-Cal is not what it needs to be.”

The number of providers participating in Medi-Cal has dropped, Bonta said, because they lose money on Medi-Cal patients and can’t afford to take on too many of them.

Legislation to restore Medi-Cal rates has been floated before and failed. Bonta said those efforts were setting the groundwork for this push. Continue reading

More Pressure on Providers in Face of Medi-Cal Expansion

Dr. Davi Pakter, of Berkeley LifeLong Clinic, prepares to see patients. (Julie Small/KQED)

Dr. Davi Pakter, of Berkeley LifeLong Clinic, (right) prepares to see patients. (Julie Small/KQED)

Medi-Cal — the public health insurance program for low-income Californians — is growing faster under federal health care reform than the state expected. Twelve million residents — nearly a third of the state’s population — now rely on Medi-Cal, and that’s increased pressure to find more doctors willing and able to treat patients for what has historically been low reimbursement rates.

At the LifeLong Clinic in West Berkeley most of the patients waiting to see a doctor are on Medi-Cal. Among them, 26-year-old Amanda Hopkins, says she enrolled half a year ago when the state expanded the benefits program.

“It’s been relieving to have Medi-Cal and know that if something happened — I needed an ambulance or there was an emergency — I wouldn’t have to worry about being in debt thousands of dollars,” she said. Continue reading

Schools Helping Families Enroll in Covered California and Medi-Cal

A parent talks to a health care enrollment specialist at a health insurance sign-up event at Natomas Unified in Sacramento. (Courtesy: The Children's Partnership)

A parent talks to a health care enrollment specialist at a health insurance sign-up event at Natomas Unified in Sacramento. (Courtesy: The Children’s Partnership)

By Jane Meredith Adams, EdSource

With huge numbers of California children still uninsured, schools are beginning to take the lead in letting families know that affordable health care coverage is available.

The deadline to sign up for a Covered California plan is this Sunday.
In school libraries and courtyards from Sacramento to Los Angeles and beyond, trained enrollment counselors have been invited to set up folding tables, commandeer desk space and corral parents before the Feb. 15 sign-up deadline for Covered California, the state’s health insurance marketplace created under the Affordable Care Act.

And the outreach will increase. Under a new state law, all California schools must include in their 2015-16 enrollment packets information about options for health care coverage and how to get help with the sign-up process. The law, Assembly Bill 2706, authored by Roger Hernández, D-West Covina, is intended to reduce the number of children who are eligible for health insurance subsidies but remain uninsured. Continue reading

Half of California’s Children Now Covered by Medi-Cal

Sarah Boone, a behavior analyst with the social services agency EMQ FamiliesFirst, evaluates Ernesto Santiago, 6, of San Jose for autism therapy services. (Barbara Feder Ostrov/Kaiser Health News)

Sarah Boone, a behavior analyst with the social services agency EMQ FamiliesFirst, evaluates Ernesto Santiago, 6, of San Jose for autism therapy services. (Barbara Feder Ostrov/Kaiser Health News)

By Barbara Feder Ostrov, Kaiser Health News

California’s Medi-Cal program has grown to cover nearly half of the state’s children, causing policymakers and child advocates to question the ability of the taxpayer-funded program to adequately serve so many poor kids.

In the past two years alone, the program has added nearly 1 million young people up to age 20, including those newly eligible for Medi-Cal coverage under the Affordable Care Act. The increase brings the total number of young people on Medi-Cal to 5.2 million, more than ever before.

Medi-Cal is California’s version of Medicaid and the largest program of its kind in the nation.

Many pediatricians and specialists already refuse to accept new Medi-Cal patients, at least in part because the program offers among the lowest payment rates in the country. New rate cuts took effect this January. Health care advocates say adding more children to the mix will only worsen the likelihood of timely treatment. Continue reading

Governor Appoints New Director of Health Care Services

Jennifer Kent was  most recently executive director of Local Health Plans of California.

Jennifer Kent was most recently executive director of Local Health Plans of California. (Courtesy: DHCS)

By David Gorn, California Healthline

On Monday, Gov. Jerry Brown (D) appointed Jennifer Kent as the new director of the Department of Health Care Services, a $9 billion state agency that oversees the Medi-Cal program.

DHCS is the agency that oversees Medi-Cal.    
Kent had most recently been the executive director of Local Health Plans of California, an organization representing 14 not-for-profit public health plans across the state.

“I’m very excited,” Kent said. “It’s a big job, so I’m both thrilled and a little overwhelmed.”

Kent replaces Toby Douglas, who was DHCS director for the past four years. Kent has worked at DHCS in the past — in fact, she and Douglas were both deputy directors in the department at the same time. Kent worked at the department from 2004 to 2007. She headed legislative affairs for Gov. Arnold Schwarzenegger (R) and has experience in both the public and private spheres of health care. Continue reading

Judge Rules on Medi-Cal Backlog, Orders Timely Access to Benefits

(s_falkow: Flickr)

(s_falkow: Flickr)

By David Gorn, California Healthline

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 and the first open enrollment period for Covered California brought millions of applications to the door of the Department of Health Care Services, which oversees Medi-Cal.

Computer issues hampered the processing of many of those applications, and in March 2014 the backlog of unprocessed claims peaked at more than 900,000 applications. It took many months to clear the bulk of those applications. Some of them are still hanging fire almost a year later, said Jen Flory, senior attorney in the Sacramento office of the Western Center on Law and Poverty. Continue reading