On March, 4, 2016, the Department of Managed Health Care (DMHC) held a public meeting on the proposed takeover of Cigna by Anthem Blue Cross. The public meeting was requested by consumer groups including Health Access, Consumers Union, and others to raise questions about the structure of the deal, its potential impact on California’s patients […]
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 […]
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 […]
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 […]
Covered CA Unveils Next Stage of Delivery System Reform: Highlights from January 21, 2016 Board Meeting
Thursday’s Covered CA Board meeting featured an overview of certification parameters for Qualified Health Plans (QHPs) to be offered in 2017, proposed changes in benefit design, and new data-driven initiatives to improve quality and equity over time. As Governor Brown said proudly in his State of the State address earlier that day, California has “wholeheartedly […]
Federal Officials Approve New “Medi-Cal 2020” Waiver Renewal
Earlier today the U.S. Centers for Medicaid and Medicare Services (CMS) officially approved California’s “Medi-Cal 2020” waiver renewal for the next five years, providing new resources and new flexibility to deliver better care for the millions of low-income Californians who rely on Medi-Cal for their health coverage. The new waiver also includes support for a […]
Covered CA Board Meeting November 19, 2015: Highlights for Consumer Advocates
This week’s Covered California Board meeting, the last for 2015, focused on the Covered CA bus tour and related OE3 campaigns; early results from Open Enrollment 3 or OE3; how the Section 1332 waiver (an option within the Affordable Care Act to waive certain ACA provisions to demonstrate a new principle or model at the […]
Obamacare in the Ballot Box: Quick Take on Kentucky Governor’s Race from California
Heading into last Tuesday’s mid-term election, there was plenty at stake for the future of health reform (HBO’s John Oliver tried to warn us), particularly in states that have refused or have yet to decide whether to implement the optional Medicaid expansion—or had decided, like Kentucky, to opt in, not because the political winds were blowing […]
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 […]
Q & A with the California Office of the Patient Advocate OPA: 2015-16 Report Cards Release
Background Last week the California Office of the Patient Advocate released the newest edition of its 2015/16 Quality Report Cards. The Report Cards provide a tool to assist Californians in comparing quality scores for health plans and medical groups in order to make fully informed health care decisions based on the latest quality data and not […]