CSAC Bulletin Article

New Medicaid Waiver Bills Moving Along

May 5, 2106

Two identical bills which would implement California’s new Medicaid Section 1115 “Medi-Cal 2020” Wavier, are currently moving through the Legislature. The new waiver, which was approved in December 2015, builds on the success that California has achieved in expanding coverage, transforming care, and improving health outcomes since the implementation of the ACA. Medi-Cal 2020 includes $6.2 billion in federal funds over five years, including:

· Global Payment Program: intended to incentivize primary and preventive care to the remaining uninsured through a value-based payment structure, up to $236 million over five years.

· Public Hospital Redesign and Incentives in Medi-Cal (PRIME): a successor to the Delivery System Reform Incentive Program that will provide $3.27 billion for designated public hospitals and $466.5 million for district and municipal hospitals.

· Whole Person Care: up to $300 million in matching funds per year for five years for county-based pilots to coordinate health, behavioral health, and social services to improve beneficiary health and well-being.

· Dental Transformation Initiative: up to $750 million total over five years to improve preventive care and continuity of care. The dental incentive funds do not have a local match requirement.

Both of the bills, SB 815 (Hernandez) and AB 1568 (Bonta), were passed out of their respective Health Committees on May 3. The bills were then referred to their respective Appropriations Committees, where they will be heard next. CSAC strongly supports both SB 815 and AB 1568, as does the California Association of Public Hospitals.

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