In a letter dated February 6, 2012, the Centers for Medicare & Medicaid Services (CMS) denied California's request to amend its 1115 Demonstration program by imposing a number of co-pays in its Medi-Cal (Medicaid) program. The proposed co-pays would have required recipients to pay $5 for doctor and dental visits, $3 for preferred prescription drugs, $50 for emergency room visits, and a maximum of $200 for a hospital stay. [More]
Boston, MA, January, 2012 – PCG Health was recently selected as the state of California’s Health Care Options (HCO) Program consultant. HCO coordinates activities in the managed care counties that include outreach, oversight of beneficiary education, and processing plan enrollment and disenrollments. PCG will help the program to define a business model to ensure that its Enrollment Broker contract has the ability to accommodate health care reform changes to Medi-Cal over the coming years. For more information, contact firstname.lastname@example.org.
On October 27, 2011, the California Department of Health Care Services announced that the Centers for Medicare and Medicaid Services (CMS) has approved a number of provider reimbursement cuts in the state’s Medicaid program. The specific proposals approved by CMS are a 10 percent provider payment reduction on a number of outpatient services, including physicians, clinics, optometrists, therapists, laboratories, dental, durable medical equipment, and pharmacy; a 10 percent payment reduction for freestanding nursing and adult subacute facilities; and a 10 percent provider payment reduction and rate freeze for distinct part/nursing facility-B services. [More]
The UCLA Center for Health Policy Research has released two excellent May 2011 reports forecasting the impact of the Affordable Care Act (ACA) on health care enrollment and coverage in California. UCLA estimates that up to 4.57 million Californians uninsured or underinsured in 2009 will be eligible in 2014, including 2.13 million who will be eligible for Medi-Cal, 1.71 million other uninsured persons who will qualify for subsidized coverage (as a function of modified, adjusted gross income) through the California Health Benefits Exchange, and 737,000 persons with individual health policies who may chose to obtain such coverage through the Exchange. [More]