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
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