Updates On California Governor Newsom’s 2019-20 Medi-Cal Budget Proposal

Jan 28, 2019 | Legislation/ Budgets/ Macro, Medicaid

For FY2019-20, Governor Newsom’s Budget includes $158.6 billion for all Health and Human Services programs. The Budget allocates $100.7 billion to Medi-Cal, California’s Medicaid program, which is projected to cover approximately 13.2 million Californians in 2019-20. Currently, a large share of Medi-Cal spending occurs in the first year or last year of life, or among enrollees with serious mental illness, hypertension, and diabetes. The Budget proposes a series of changes and investments to improve the availability of health care and address the social determinants of health, which this...

MedPAC Finalizes Payment Update Recommendations At January Meeting

Jan 23, 2019 | MedPAC

The Medicare Payment Advisory Commission (MedPAC) held its first public meeting of 2019 last week. MedPAC voted on recommendations for 2020 Medicare payment updates – most of which were discussed in its December meeting. This brief reviews these recommendations, and other topics discussed at last week’s public meeting. Click to read more.

Federal Court Decision Stops Cuts To 340B Reimbursement

Jan 22, 2019 | 340B, Hospitals

A judge for the US District Court of DC recently decided that CMS and HHS exceeded statutory authority when they implemented Part B payment cuts for 340B drugs beginning in 2018. The court issued a permanent injunction that returns the 2018 rates to 2017 levels, but the court has yet to decide on a financial remedy for the lower 2018 rates. The decision will likely be appealed by the administration and continue to develop. This brief provides an overview of the issue. Click to read more.

Federal Exchange Plan Selection Down 4% Due To Fewer New Consumers

Jan 16, 2019 | Exchanges

In the 39 states that use the Federal healthcare.gov website for Exchange enrollment, 3.8% fewer consumers selected a 2019 plan than last year. This decline – although lower than in prior years – was entirely due to fewer new consumers, rather than existing consumers. It likely reflects a combination of factors, including better accessibility of other coverage sources, less marketing and outreach from the Administration, and the elimination of the financial penalty associated with the individual mandate. Click to read more.

Autism CPT Codes Made Permanent In 2019

Jan 15, 2019 | Autism, Behavioral

Stakeholders worked with the American Medical Association (AMA) to make Applied Behavior Analysis (ABA) codes permanent, effective January 1, 2019. The change is viewed favorably by ABA providers. In addition to other small changes, it is expected that payers will have more difficulty challenging the legitimacy of service. This brief highlights some of the changes. Click to read more.