Measures to Restore Medi-Cal Provider Rate Cuts Face Fiscal Committees

Two measures – one in each House – designed to restore deep Medi-Cal provider reimbursement cuts face tough sledding in the Legislature’s fiscal committees. 

AB 900, by Assembly Member Luis Alejo, would restore 10 percent rate cuts for Medi-Cal fee-for-service providers and restore the reimbursement cuts for distinct part skilled nursing facilities (DP/SNFs). These significant rate cuts were passed in 2011at the height of the Great Recession and during a time when California’s legislators were grappling with a $25 billion budget deficit. Compounding the devastating effects of the cuts is the fact that DP/SNFs must retroactively reimburse the state for more than two years of the rates paid to them before the cuts were declared legal. 

The Assembly Appropriations Committee estimates that the restoration of these cuts would cost $140 million in the current year and possibly more than $573 million in the budget year (2013-14). Due to the cost, the Committee placed AB 900 on their Suspense File. The Assembly Appropriations Committee passed AB 900 on May 23. 

A second measure, SB 640 by Senator Ricardo Lara, seeks to restore all provider rate cuts – including the cut outlined in AB 900 – enacted in the past two budget years. This measure has broad support among a large coalition of doctors, hospitals, counties and other stakeholders, but has triggered fiscal concerns from the Senate Appropriations Committee due to a total three-year price tag of $928 million (which includes retroactive payments). The Senate Appropriations Committee held SB 640 in committee on May 23. 

A wide coalition of hospital representatives, doctors, county affiliates, health advocates and legislators from both sides of the aisle support the measures. CSAC specifically supports the elimination of the AB 97 rate cuts to distinct part skilled nursing facilities and the retroactive payments associated with those cuts due to the significant negative impacts on both rural and urban DPs/SNFs and residents’ access to health care facilities. 

Despite the action by the fiscal committees this week, the restoration of Medi-Cal provider rate cuts will continue to be part of the larger state budget conversation. 

Public Health

AB 506 (Mitchell) – Support
As Introduced on February 20, 2013

AB 506, by Assembly Member Holly Mitchell, would authorize social workers
and health care providers to consent to an HIV test for a child under the age of one year who is in temporary custody or is a dependent child of the court. The Senate Human Services Committee will hear AB 506 on June 11. The measure has also been referred to the Senate Judiciary Committee.
Suspense File Legislation

Human Services

AB 260 (Gordon) – Support
As Amended on April 24, 2013

AB 260, by Assembly Member Richard Gordon, would remove the sunset date for the Child Care Subsidy Pilot projects in San Mateo County and extend the sunset date in San Francisco City and County to July 1, 2016. The Assembly Appropriations Committee passed AB 260 on May 24, 2013. 

SB 283 (Hancock) – Support
As Proposed to be Amended 

SB 283, by Senator Loni Hancock, would allow those who have been convicted of a felony after 1996 and who meet all current eligibility requirements to receive CalFresh services. Senator Hancock amended the measure in the Senate Appropriations Committee to reduce the potential for incurring costs. 

Based on the proposed amendments, the Senate Appropriations Committee passed SB 283 off of their Suspense File on May 23. The measure now goes to the Senate floor. 

Public Health

AB 720 (Skinner) – Support
As Amended on April 11, 2013

AB 720, by Assembly Member Nancy Skinner, would help reduce recidivism and assist counties in our responsibility for post release community supervision of individuals in county jails by enrolling them in the federally funded Medi-Cal program before their release.

Assembly Bill will give counties an important tool to reduce repeat crime and recidivism by allowing newly released inmates to access critical health care and substance use disorder services through Medi-Cal, or, if they qualify, through a qualified health plan in the state’s health benefits exchange. By pre-enrolling incarcerated individuals, counties can get a jump on providing wrap-around services to the most high-risk inmates to ensure adequate supervision and successful and sustainable reentry in our communities. Amendments will clarify that the county may designate which agency and staff is assigned to the jail to make eligibility determinations. 

CSAC supports efforts to increase local flexibility and innovation in serving the AB 109 and county jail population because the benefits of successful reintegration of incarcerated individuals accrue to a variety of stakeholders, including counties, the state, our local communities and families. It is for these reasons that CSAC supports AB 720. The Assembly Appropriations Committee passed AB 720 on May 24, 2013. 

Medical Care

AB 361 (Mitchell) – Support
As Amended on April 4, 2013

AB 361, by Assembly Member Holly Mitchell, would allow the state and counties to work together to leverage significant federal funding and create a patient-centered “health home” program for Medi-Cal beneficiaries who are frequent hospital users. 

Specifically, the measure would allow California to utilize a 90 percent federal funding match for two years under the Affordable Care Act to create a comprehensive program for frequent hospital users. The funding can be used to implement comprehensive engagement and case management services to high-risk populations and will help promote an integrated approach (“health home”) to health care and wellbeing for the most chronically ill people in our communities. The program goal is to stabilize – and even increase – the health of frequent hospital users while reducing their utilization of costly medical care. 

The Assembly Appropriations Committee passed AB 361 on May 24, 2013.