CDCAN
CALIFORNIA DISABILITY COMMUNITY ACTION NETWORK
DISABILITY RIGHTS
NEWS REPORT
#0022-2006  February 17, 2006 Friday
Advocacy Without Borders:
Connecting people with disabilities & seniors to rights and unified action

1225 8th Street Suite 480 - Sacramento, CA 95814  916/446-0013  Fax: 916/446-0026
Marty Omoto - director  email: martyomoto@rcip.com    website: www.cdcan.us

 
 California Legislative Update
*
GOV. SIGNS SB 912 - EFFECTIVE IMMEDIATELY
* REPEALS 5% MEDI-CAL PROVIDER RATE CUT
* ADVOCATES PRAISE ACTION BY THE GOVERNOR

SACRAMENTO -  Gov. Arnold Schwarzenegger signed on Friday (February 17) SB 912 by Sen. Denise Ducheny (D-San Diego) which repeals a 5% rate reduction for Medi-Cal providers that went into effect January 1, 2006.  The emergency legislation was filed with the Secretary of State on Friday (February 17), Chapter 8 Statutes of 2006, and goes into effect immediately but does not include Medi-Cal managed care plans.  Disability and senior advocates praised the action by the Governor and the Legislature. 

The legislation does the following:
* Repeals the existing 5% Medi-Cal provider rate reduction, originally proposed by Governor Davis and passed by the Legislature as part of the 2003-2004 State Budget, beginning 14 days after the effective date of this bill, to the extent federal funding is available.  The effective date of the bill is February 17.
* Repeal of this reduction does not apply to Medi-Cal payments to managed health care plans. 
* Includes language that the Legislature intends that the bill will mean that the Department of Health Services shall take all administrative steps necessary to implement the repeal.
* Appropriates $22.5 million from the state General Fund money and $22.8 million in federal matching funds to cover the cost of changes in Medi-Cal   provider reimbursement rates as a result of this bill.
* Includes an urgency or emergency provision allowing this bill to take effect immediately upon enactment. 


Governor Says Repeal Possible Due to Recalculation of Medicare Part D Funding
The Governor said he was signing the legislation
"...because of the efforts of my Administration and the leadership of other states, the federal
government recently announced that California will save $113 million through a recalculation of the Medicare Part D payment formula. These unanticipated savings provide us the opportunity to end the rate reduction currently in place and provide relief for Medi-Cal fee-for-service providers who deliver critical health care services to our most vulnerable Californians."

The Governor did warn however that while the new federal funds would help to cover the cost of rescinding the rate cut, which will increase state spending for Medi-Cal, the "...rising costs in the Medi-Cal program demand attention and require action. As the Public Policy Institute of
California recently reported, Medi-Cal spending has increased by more than 30% in five years and may increase by more than 60% to almost $54 billion by 2010. Without implementing real cost containment efforts in Medi-Cal, California will be seriously challenged to maintain eligibility and sustain the current level of services in the future."

Sen. Ducheny said that the Governor's approval of SB 912 "...ensures that Medi-Cal recipients will continue to have access to quality healthcare. Rate cuts mean we lose doctors and other healthcare providers which exacerbates the instability of our state’s healthcare safety net. I was happy to author this emergency legislation to provide security to Californians who most need our help.”

According to the Schwarzenegger Administration, the impact of rescinding the the 5% Medi-Cal rate reduction will increase state spending by approximately $50.8 million in state funds  ($13.2 million in the July 2005-June 2006 state budget year and $37.6 million in July 2006-June 2007 state budget year).  SB 912  appropriates $22.5 million in state money and $22.8 million in federal funds to the California Department of Health Services  to pay for the increased costs in the Medi-Cal program as a result of repealing the Medi-Cal provider rate reduction.  The state funds will be matched by approximately the same amount in federal dollars.

Disability and seniors and other advocates
strongly backed SB 912 saying that California's Medi-Cal reimbursement rates are already among the lowest in the nation, which resulted in a growing number of doctors and other providers who were forced to leave the program, reducing access to health care for millions of Medi-Cal recipients across the State, especially in rural counties.  
     

Background
* January 2003: Governor Gray Davis proposed in January 2003, as part of the July 2003-June 2004 state budget a 5% reduction in the amount of money paid to Medi-Cal providers.
* July 2003: The Legislature passed and Gov. Davis signed into law, AB 1762 , Chapter 230, Statutes of  2003, enacted the 5% Medi-Cal provider rate reduction to be effective for calendar years January 1, 2004 through December 31, 2006. 
* October 2003: Gov. Davis was recalled by voters and Arnold Schwarzenegger was elected governor. 
* November 2003: Arnold Schwarzenegger assumed office and later that month submitted proposals for immediate major reductions to the state budget, including proposed suspension of the Lanterman Developmental Disabilities Services Act, considered by advocates as the civil rights act for children and adults with developmental disabilities, and moving forward with the Medi-Cal provider rate reduction that would go into effect the following January. 
* December 2003: Before the reduction became effective the California Medical Association  and other advocacy organizations and groups representing Medi-Cal providers and Medi-Cal recipients, including people with disabilities and seniors, filed a lawsuit in a federal court in Sacramento, against the State to stop the reductions from taking place. They argued to the federal court, that the reductions were illegal because the State did not follow federal Medicaid law and did not consider how the reductions would impact access to healthcare by Medi-Cal recipients.
* December 23, 2003:  The United States District Court for the Eastern District of California handed down an order that stopped the State from implementing the reductions.  The Schwarzenegger Administration appealed the ruling the US 9th Circuit Court of Appeals. That court combined the Medi-Cal case with another lawsuit, Sanchez v. Johnson,  dealing with persons with developmental disabilities who were Medi-Cal recipients and their right to sue the State for increased funding for community-based services and supports.
* August 2, 2005: The US 9th Circuit found for the two combined cases that "private parties", such as Medi-Cal recipients and providers, do not have a right to challenge California's compliance with federal Medicaid law. The immediate impact of the ruling was to lift the Federal District Court's December 2003 injunction that temporarily stopped by the Medi-Cal provider rate reduction from being implemented. The US 9th Circuit Court ruling reinstated the State law requiring a 5% provider rate reduction for the period January 1, 2004, to December 31, 2006, though it never went into effect. The State in theory, had the right to implement the reduction retroactive for Medi-Cal providers back to January 1, 2004 - an action which nearly every advocate and state official agreed would "devastate" Medi-Cal providers. 
* October 7, 2005: Governor signed into law AB 1735, 
Chapter 719, Statutes of 2005, by Assemblymember De La Torre which rescinded the Medi-Cal 5% provider rate reduction between January 1, 2004 and December 31, 2005.  However the bill did allow the Medi-Cal 5% provider rate reduction to take effect beginning on  January 1, 2006 to December 31, 2006.
* January 2006: Governor proposes in his July 2006-June 2007 state budget assumes that the Medi-Cal provider rate reduction will be in effect from January 1, 2006 through December 31, 2006.  He does not call for extending the rate reduction beyond that date however.
* January 26, 2006: Sen. Ducheny amends SB 912 with provisions calling for repealing the Medi-Cal provider rate reduction. 
* February 14 2006: Passed Assembly Floor 76-0
* February 16, 2006: Passed Senate Floor 31-0 and was sent to the Governor.
* February 17, 2006: Governors signs SB 912 and the bill is enacted (chaptered by the Secretary of State) on that date

SUMMARY OF SB 912:
SB 912 - Medi-Cal Provider Rates
Author: Sen. Denise Ducheny (D-San Diego)
Status:  Approved by the Governor on February 17, 2006.  Chaptered by the Secretary of State, Chapter 8, Statutes of 2006 on February 17, 2006.  Goes into effect immediately as an urgency (or emergency) bill.
What the bill does:
* Repeals the existing 5% reduction in Medi-Cal provider payments beginning 14 days after the effective date of this bill, to the extent federal funding is available.  The effective date of the bill is February 17.
* Repeal does not apply to Medi-Cal payments to managed health care plans. 
* States legislative intent that the Department of Health Services shall take all administrative steps necessary to implement this bill.
* Appropriates $22.5 million from the state General Fund and $22.8 million in federal matching funds to cover the cost of changes in Medi-Cal 
provider reimbursement rates as a result of this bill.
* Includes an urgency or emergency provision allowing this bill to take effect immediately upon enactment.

Governor's Signing Message:
"I am signing Senate Bill 912, to permanently eliminate a 5% Medi-Cal provider rate cut initiated by the previous Administration and mandated by legislation in 2003. Because of the efforts of my Administration and the leadership of other states, the federal government recently announced that California will save $113 million through a recalculation of the Medicare Part D payment formula. These unanticipated savings provide us the opportunity to end the rate reduction currently in place and provide relief for Medi-Cal fee-for-service providers who deliver critical health care services to our most vulnerable Californians.
While new federal funds will help cover the cost of this rate increase, rising costs in the Medi-Cal program demand attention and require action. As the Public Policy Institute of California recently reported, Medi-Cal spending has increased by more than 30 percent in five years and may increase by more than 60 percent to almost $54 billion by 2010.
Without implementing real cost-containment efforts in Medi-Cal, California will be seriously challenged to maintain eligibility and sustain the current level of services in the future. I call on the California Medical Association and other health care providers to work with me and the Legislature to develop and implement the types of reasonable and responsible Medi-Cal reforms that I have proposed to contain costs, maintain services and improve outcomes for Medi-Cal beneficiaries.
Sincerely, Arnold Schwarzenegger"

Impact to People with Disabilities and Seniors:  Major impact - access to health care is a huge issue, and a major critical component for hundreds of thousands of children and adults with developmental and/or other disabilities and seniors who are Medi-Cal recipients to remain in their own homes and in community-based services.
CDCAN Vote Record Report:  Will be published in next CDCAN report

REMINDER
* CDCAN Disability Rights Townhall Telemeeting - FEB 21, 1PM to 2:45 PM, sponsored by California NAELA and Santa Barbara County's CHANCE Inc (a housing coalition for people with developmental disabilities) on Medi-Cal issues, including update on SB 912, brief update on Medicare Part D, and major focus on impact of passage of the federal "Deficit Reduction Act" and its impact on Medi-Cal, and people with developmental and other disabilities and seniors, their families, workers, organizations.  Will feature officials from California Department of Health Services, including Stan Rosenstein, head of the state's Medi-Cal program.  Townhall telemeetings are free - and a means for people with disabilities, seniors, their families, workers, organizations and other advocates to participate in policy making no matter where they are.  CDCAN says it is part of their "Advocacy without borders" program. 
To participate: 
* Step One:  Dial toll-free 1-888-346-5716  (NO passcode!)
* Step Two: Tell the operator you want to join the CDCAN Townhall Telemeeting
* Step Three: The operator will connect you
Go to the CDCAN website at www.cdcan.us for more information. 


How To Receive CDCAN Capitol News Reports and Alerts
The California Disability Community Action Network is a non-partisan link to thousands of Californians with developmental and other disabilities, people with traumatic brain and other injures, seniors and their families, community organizations and providers, direct care and other workers, and other advocates. These action alerts and news reports is for all of them.   If you would like to get on this distribution (and conversely, get off of  it) please send an email with that  request to:  martyomoto@rcip.com OR sign up via the NEW CDCAN website at www.cdcan.us  Sharing information is part of our organizing effort. Please feel free to forward or copy  this (attribution is nice but not necessary). We're all in this together!