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The health care insurers, nonprofit organizations, and other groups responsible for implementing Gov. Gavin Newsom鈥檚 ambitious plan to infuse Medicaid with social services say their ability to serve vulnerable, low-income Californians is hamstrung.
California鈥檚 Medicaid program is making it easier for people with diabetes to obtain the supplies and equipment they need to manage their blood sugar, partly by relaxing preauthorization requirements that can cause life-threatening delays.
Dignity Health is suing several patients and their advocates for 鈥渃ommercial blockade鈥 for refusing discharge during the covid-19 pandemic. The lawsuits could set precedents for use of the California commercial blockade statute, conceived to constrain abortion protesters, and how hospitals handle discharges.
Teresa Johnson has been in extreme pain for more than a year after what she believes was a severe allergic reaction to iodine. Her Medi-Cal plan approved her referral to a specialist, but it took her numerous phone calls, multiple complaints, and several months to book an appointment.
Federal officials are trying to clamp down on private arrangements among some hospitals to pay themselves back for the Medicaid taxes they鈥檝e paid. State health officials and the influential hospital industry argue that regulators have no jurisdiction over the agreements.
Pasha Wrangell has faced delays getting gender-affirming care because of red tape and limited providers. Over more than two years, Wrangell has received only about half the total electrolysis sessions recommended. Wrangell鈥檚 insurer through Medi-Cal, California鈥檚 Medicaid program, acknowledges the shortage of practitioners.
State officials have promised to boost funding for California鈥檚 Medicaid program by $11.1 billion starting next year, with most of that money earmarked for higher payments to doctors, hospitals, and other providers. But the details have yet to be worked out, and powerful health industry groups are jockeying for position.
California officials recently agreed to give new parolees a 60-day supply of their prescriptions and promised to replace lost medical equipment in the month after they鈥檙e released from prison. The state also agreed to submit Medi-Cal applications on their behalf at least 90 days before they are released.
When Medi-Cal beneficiary Lloyd Tennison moved last year from Contra Costa County to San Joaquin County, he was bumped off his managed care plan without notice before his new coverage took effect. His case highlights a chronic issue in California鈥檚 fragmented Medicaid program.
Annie Malloy, of San Diego, is among the first to receive a new housing move-in benefit from Medi-Cal, California鈥檚 Medicaid program. It鈥檚 an effort to help homeless and near-homeless people who might otherwise rack up huge medical bills.
California Healthline has learned that a coalition of doctors, hospitals, insurers, and community clinics want to lock in a tax on health insurance companies to draw in extra Medicaid funding. It also wants to make the tax permanent.
As hospitals squeeze Democratic leaders in Sacramento for more money, health care finance experts and former state officials warn against falling for the industry鈥檚 fear tactics. They point to healthy profits and a recession-era financing scheme that allows rich hospitals to take tax money from poorer ones.
California鈥檚 safety-net health program has resumed annual eligibility checks after three years, which means beneficiaries will need to provide updated personal information to maintain coverage. Here鈥檚 what to watch for.
A Medi-Cal patient illustrates how early schizophrenia treatments can yield big benefits. Advocates want California to expand such services to more people living with severe mental illness, which they argue will not only improve lives but also save money over time.
Gov. Gavin Newsom鈥檚 ambitious experiment in health care is supposed to cut costs as it fills the needs of hard-to-reach people. The program鈥檚 start is chaotic and limited, but it shows promise.
Gov. Gavin Newsom declared that California would cut ties with Walgreens after the company said it would not distribute abortion pills in some states. But federal rules make it difficult for the state to unwind its Medicaid prescription drug agreement, which paid Walgreens $1.5 billion last year.
Gov. Gavin Newsom is making a bold push for Medicaid health plans to provide more housing support. He argues it鈥檚 cheaper to pay for rent than to allow homeless people to fall into crisis, which requires costly care in hospitals, nursing homes, and jails.
The state wants to stop paying Kaiser Permanente for treating severely mentally ill Medi-Cal patients in Sacramento and Solano counties and force the counties to take on the task. The counties鈥 leaders say they can鈥檛 afford it.
Medi-Cal serves more than one-third of the state鈥檚 population 鈥 offering a dizzying range of care to a diverse population. In the new 鈥淔aces of Medi-Cal鈥 series, California Healthline will assess the program鈥檚 strengths and weaknesses through the lives and experiences of its enrollees.
California has enrolled into Medi-Cal more than 300,000 older immigrant adults lacking legal residency since May, but the state doesn鈥檛 know how many more might be eligible. Community workers are now searching for them.
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