Match game

Calif. groups eye fed­eral Med­i­caid dol­lars

Modern Healthcare - - The Week In Healthcare - Gregg Blesch

The Cal­i­for­nia Hospi­tal As­so­ci­a­tion is hope­ful that Gov. Arnold Sch­warzeneg­ger’s sig­na­ture on a bill last week means the state will move for­ward on a plan to at­tract a stim­u­lus-sweet­ened match of fed­eral Med­i­caid dol­lars by levy­ing fees on hos­pi­tals.

The money, how­ever, is nowhere near in the bag be­cause the bill’s back­ers were forced to gut key pro­vi­sions in or­der to get it through the state’s po­lit­i­cally ran- corous Leg­is­la­ture.

The tem­po­rary fee on hos­pi­tals was con­ceived to take ad­van­tage of a 62% match rate—up from 50%—in ef­fect for Cal­i­for­nia through the end of 2010 un­der the Amer­i­can Re­cov­ery and Rein­vest­ment Act of 2009. The hospi­tal as­so­ci­a­tion es­ti­mates the plan would cre­ate $2.3 bil­lion in new fed­eral money, mostly to fund sup­ple­men­tal pay­ments to hos­pi­tals by Medi-Cal, the state’s Med­i­caid pro­gram.

About $320 mil­lion would go to­ward ex­pand­ing state-funded chil­dren’s health in­sur­ance, the as­so­ci­a­tion said. Also spon­sor­ing the bill were the Cal­i­for­nia Chil­dren’s Hospi­tal As­so­ci­a­tion and six-hospi­tal Daugh­ters of Char­ity Health Sys­tem, based in Los Al­tos Hills.

With Repub­li­can se­na­tors re­fus­ing to act on bud­get mea­sures, the bill’s leg­isla­tive sup­port­ers were forced to pass the bill with a sim­ple ma­jor­ity. In or­der to do so, they stripped the funds ap­pro­pri­ated for im­ple­men­ta­tion, the au­thor­ity to dis­perse any of the money raised and a clause that would have made the bill ef­fec­tive im­me­di­ately. The “ur­gency clause” would have al­lowed state of­fi­cials to start pur­su­ing fed­eral ap­proval of the plan.

Sch­warzeneg­ger noted in a sign­ing state­ment that sim­i­lar provider fees were part of his failed pro­posal in 2007 to over­haul health­care in the state, but that the bill that

reached his desk re­quires sub­se­quent action from the Leg­is­la­ture.

Anne McLeod, the Cal­i­for­nia hospi­tal as­so­ci­a­tion’s vice pres­i­dent for fi­nance pol­icy, said the gov­er­nor’s sig­na­ture was an en­cour­ag­ing step. “We think we can see this through,” McLeod said, sug­gest­ing that state of­fi­cials might be able to be­gin talks with the CMS so the fees can be im­ple­mented quickly as soon as law­mak­ers fill in the holes. “Hope­fully the state will de­cide they have the re­sources avail­able to ad­dress th­ese pre­lim­i­nary ne­go­ti­a­tions.”

But a spokesman for the Cal­i­for­nia Health Care Ser­vices Depart­ment said that the bill won’t al­low that. “It opens the gate, and now we have to pur­sue the leg­is­la­tion and get the ap­pro­pri­a­tion and im­ple­men­ta­tion au­thor­ity and go from there,” spokesman Tony Cava said. “At this point, there’s re­ally noth­ing we can do un­til we get fur­ther leg­is­la­tion.”

McLeod: “We think we can see this through.”

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