CMS Rejects California's Plan To Require Medi-Cal Copayments & Gov. Brown Lobbies for Medi-Cal Waiver During Washington, D.C., Visit

CAL/AAEM News Service calaaem.news.service1 at gmail.com
Thu Mar 8 23:44:06 PST 2012


 

Description: Description: Description: Description: CAL/AAEM: California
Chapter of the American Academy of Emergency Medicine

February 07, 2012

 

CMS Rejects California's Plan To Require Medi-Cal Copayments

 

CaliforniaHealthline
<http://www.californiahealthline.org/articles/2012/2/7/cms-rejects-californi
as-plan-to-require-medi-cal-copayments.aspx#ixzz1nqzqwO8q> 

 

 

On Monday, CMS said that California cannot require Medi-Cal beneficiaries to
take on copayments for physician visits and prescription drug purchases, the
Sacramento Bee's "Capitol Alert" reports. Medi-Cal is California's Medicaid
program (Yamamura, "Capitol Alert," Sacramento Bee, 2/6).

 

Background

The copay proposal was passed as part of last year's state budget. Gov.
Jerry Brown (D) and state lawmakers said the requirement would save $511
million annually.

 

Under the proposal, Medi-Cal beneficiaries would have been required to pay:

.         A maximum of $200 for hospital stays;

.         $50 for an emergency department visit;

.         $5 for visiting a physician or dentist visit; and

.         $3 for certain prescription drugs (Lin, AP/San Francisco
Chronicle, 2/6).

Details of CMS' Decision

CMS acting Administrator Marilyn Tavenner said that while she supports the
"goal of promoting cost-effective use of health care services," federal law
prohibits states from requiring copays for medical insurance programs that
aid low-income residents (Lavelle, U-T San Diego, 2/6).

 

She added that federal officials were "unable to identify the legal and
policy support" for the copays (Kleffman, San Jose Mercury News, 2/6).

 

State Response

H.D. Palmer -- a spokesperson for the state Department of Finance -- said
that California will appeal the decision.

 

He said that if the decision is not reversed, the state would have to spend
an additional $575 million in the next fiscal year (Megerian, "PolitiCal,"
Los Angeles Times, 2/6).

 

 

 

 

February 12, 2012

 

Gov. Brown Lobbies for Medi-Cal Waiver During Washington, D.C., Visit

 

 

CaliforniaHealthline
<http://www.californiahealthline.org/articles/2012/2/27/gov-brown-lobbies-fo
r-medi-cal-waiver-during-washington-dc-visit.aspx#ixzz1nr6LBaWb> 

 

 

During a visit to Washington D.C. last week, Gov. Jerry Brown (D) lobbied
the Obama administration for a waiver that would allow the state to enact
certain Medi-Cal cuts, the Los Angeles Times reports. Medi-Cal is
California's Medicaid program.

 

Brown met with President Obama and other Democratic governors during a
meeting of the National Governors Association. He later met with HHS
Secretary Kathleen Sebelius to discuss the waiver.

 

Background

Brown is seeking authorization to charge Medi-Cal beneficiaries copayments
for emergency department visits and appointments with dentists and
physicians, beginning in October (York, Los Angeles Times, 2/27).

 

The copay proposal was passed as part of last year's state budget. Brown and
state lawmakers said the requirement would save $511 million annually.

 

Earlier this month, CMS said that California cannot require Medi-Cal
beneficiaries to take on copayments (California Healthline, 2/7).

 

Details of Meeting With Sebelius

According to Brown, Sebelius said there are legal obstacles to enacting his
Medi-Cal plan.

 

She indicated that there are other ways California could reduce program
spending but did not provide specific examples, Brown noted (Los Angeles
Times, 2/27).

 

Brown suggested that negotiations on the copay proposal still are open with
the Obama administration.

 

 

 

 

Marcus Williams &
Brian Potts MD, MBA
Managing Editors, CAL/AAEM News Service

 

 

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