Archive | Cost Containment

Labor and Consumer Groups Join Forces to Stop Surprise Medical Bills

This week, consumer and patient advocates re-launched their effort to prevent Californians from facing surprise out-of-network medical bills. Due to the failure of the legislature to act last year, California consumers continue to receive surprise medical bills from out-of-network providers after using in-network medical facilities. These bills could come from an out-of-network anesthesiologist, pathologist, radiologist […]

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Health Reform 2.0: California Starts Sec. 1332 Waiver Discussions

As part of California’s ongoing efforts to implement and improve upon health reform, last Tuesday Covered California and the California Department of Health Care Services convened an exploratory discussion of options for California under Section 1332 of the Affordable Care Act (see the panelists’ slide deck and all materials here). Under Section 1332, states may seek […]

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DHCS Stakeholder Advisory Committee Digs Deeper into Medi-Cal 2020 Waiver, SB 75 Implementation (Health4Kids), and Other Care Transformation Initiatives

This blog was written by Tam M. Ma (Policy Counsel) and Judi Hilman (Director of Special Projects) DHCS held its quarterly Stakeholder Advisory Committee today, the first time since California’s Medi-Cal 2020 waiver was approved at the end of December, covering a range of topics, including the waiver renewal, SB 75 implementation of Health for […]

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Covered CA Board Takes Big Steps on Standardized Benefit Design and Quality/Equity Measures; Considers New Barriers to Special Enrollment

Thursday’s Covered California Board meeting, the first since the last day of open enrollment 2013, offered a deep dive on the standardized benefit designs and the quality/equity framework that will guide contracting with insurers for the next 3-year cycle (2017-2019), and a heated discussion about the new documentation requirements that insurers are calling for to qualify […]

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Prescription Costs Transparency Bill Fails in Assembly Health Committee, But Fight Continues

Earlier today the California Assembly Health Committee failed to pass AB 463 (Chiu), a bill introduced last session that would have required greater transparency around the pricing of high-cost medications. Bill author David Chiu pulled the bill because he did not have enough votes, like last year, to get it through committee.  But, as he […]

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DHCS & CMS Agree to Medi-Cal 2020 Waiver Framework!

This past Saturday (Halloween), the California Department of Health Care Services announced it had reached a new “conceptual agreement” with the federal Centers for Medicaid and Medicare Services (CMS) on the general framework of “Medi-Cal 2020,” the renewal of the 2010-2015 Medi-Cal waiver. Toplines With details to be specified in the coming months, the framework is […]

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DHCS Stakeholder Advisory Committee October 14, 2015: Highlights for Consumer Advocates

Update on MCO (Managed Care Organization) Tax DHCS Director Jennifer Kent opened with an update on the MCO tax and the need to revise it to meet new federal guidelines to broaden the base to all health plans (learn more here).  Last Spring, the Governor called a special session to resolve this and related Medicaid financing […]

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Health Reform 2.0: New Efforts on Value-Based Health Care

Health Access, California Pan-Ethnic Health Network (CPEHN), and Consumers Union and other groups are teaming up to improve health and health equity for California consumers through transparency, benefit design, and Medi-Cal reforms. Through our new Value-Based Health Care initiative, supported by the Robert Wood Johnson Foundation and working with the national group Community Catalyst, Health Access and CPEHN […]

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Legislative Re-Cap: After the First Deadline…

Last Friday was the deadline for all policy committees in the California legislature to hear and report on all bills with fiscal implications–and the good news is that many key bills of interest to health care consumers have passed their first critical hearing. While some bills stalled (including almost all of those Health Access opposed but […]

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Consumer Protection Bills Move Forward, Mixed News on Transparency

Good news (mostly) for California’s health care consumers and for efforts to improve on the Affordable Care Act (ACA) out of the California Assembly Committee on Health yesterday. The Committee passed two bills designed to extend cost sharing protections to consumers in circumstances not addressed by the ACA. AB339 (Gordon), a Health Access-sponsored bill, protects […]

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