SFMS Legislative Update: Gov. Brown, Legislative Democrats Budget Deal Does Not Include Fix for Medi-Cal Cuts June 11, 2013 CMA, Medi Cal, News, Politics and Medicine California state budget, Medi-Cal cuts, AB 97 0 Reports began circulating that legislative leadership—the Speaker and Senate Pro Tem—had come to agreement on the major pieces of a budget ‘deal’ with Governor Brown. SFMS/CMA has been working to uncover the details and determine the main pieces of relevance to physicians. 10% Medi-Cal Provider Reimbursement Reductions To our knowledge, the deal does not include a fix for the rate cuts. Right before the public announcement of a deal, CMA was joined by the Calfiornia Hospital Association and SEIU-UHW in a meeting with Senate President Pro Tem Darrell Steinberg. In discussing the rate cuts, the Pro Tem committed to going to the Governor with the Speaker and securing a delay in implementing the AB 97 cuts until January 1, 2014 at the earliest, in order to allow time for a late summer/August legislative proposal to secure more funding in the Medi-Cal system through the state paying a higher rate for the expansion population (that rate increase being entirely federally funded for three years). We are anticipating receipt of a written agreement to delay within the next couple days. MCO Tax There isn't much information about what form the managed care organization (MCO) tax would take in the ‘deal’. The health plan community still doesn’t know what form the MCO takes in the deal and if they’re opposed or not. They want CMA’s support in ‘dividing the question’ and only having one year (2012-13) of MCO, at only the MCO rate to fund finally paying the Healthy Families plans. They do not want to discuss the higher sales tax rate and where that funding stream should go until after the first of July, when they see their rates for next year. County Funding Redistribution We haven’t heard much yet about the county funding scheme, but have heard many rumors about a variety of potentially problematic proposals being included in the arrangement, potentially including an extension of the Low Income Health Programs/LIHPs as well as a potential renegotiation of the 2010 Medi-Cal 1115 Waiver, which doesn’t expire until 2015. The contents of the county funding arrangement will likely impact CMA’s positioning on the remainder of the budget items impacting physicians due to its pivotal role in the restructuring and expansion of the Medi-Cal system in preparation for health reform implementation in 2014. UC Riverside Medical School The conference committee adopted action to appropriate $15 million to UCR. Their action seemed to have included the money but instead of appropriating additional funds, it was taken out of the existing UC appropriation. Next Steps The bicameral Budget Conference Committee finished their work just before 9:30 pm on June 10. Of note, the Pro Tem’s Mental Health Wellness package was approved ($142.5 million), and the DP-SNF facilities did not have their rates restored from the 2008/09 level instituted in AB 97 to the current year level, as originally proposed in the Senate Budget Subcommittee #3 on Health and Human Services. More details should be emerging about the contents of the full deal in the coming days. SFMS/CMA will continue to keep you apprised of the situation as we receive updated information. Comments are closed.
