Medi Cal

Times are tough enough for Californians; they're even tougher for Californians' teeth. "One-quarter of all adults and 28% of children in California have untreated dental caries [cavities]," says Len Finocchio, a senior program officer at the California Healthcare Foundation, a health advocacy group. "Our research tells us that many people in California have been avoiding routine care that might have cost about $100 for a checkup and cleaning, and then find themselves in the emergency room, where they get only an antibiotic, a bill that can average over $600 and instructions to see a dentist."

SACRAMENTO - Gov. Jerry Brown released a plan to close California's rapidly growing deficit by switching state offices to a four-day week, slashing welfare benefits and healthcare for the poor and relying on a variety of short-term fixes - all in the hopes that voters will give the state some breathing room by raising taxes in November. The governor, who unveiled his revised budget proposal in the Capitol on Monday, is facing a nearly $16-billion budget gap, far larger than the $9.2 billion he predicted in January.

California's budget crisis isn't reason enough to cut $1.1 billion a year in payments to doctors, dentists, pharmacists and other healthcare providers to the needy, a federal appeals court ruled Thursday. A bill passed by the Legislature last year reduced Medi-Cal compensation by 10%, driving away even more providers from the shrinking ranks still taking state patients and endangering their ability to get treatment, a three-judge panel of the U.S.

California is beginning the process of shifting 1.1 million of the state's sickest and poorest patients into managed care, which healthcare officials say will cut costs and improve treatment. The move is part of a broader state plan to continue moving residents with publicly funded health coverage into managed care, prompting concerns among critics who fear that patients could lose their current doctors. State officials announced Wednesday that Los Angeles, Orange, San Diego and San Mateo will be the first counties to provide managed care to the patients, who are enrolled in both the federally run Medicare and the state-federal Medi-Cal program.

Re "Medi-Cal effort nabs few cheaters," Oct. 6 We spent $16.6 million to deny eight people health services? As you wrote, "One congressional oversight committee found that the regulations cost the federal government and six of nine states surveyed this year $16.6 million in new administrative costs but resulted in snagging only eight illegal immigrants." The U.S. can further be proud of money-saving through its healthcare freeloading off Europe, which provides services to tourists.

The doctor chuckled with delight as the brown-haired girl smiled, chanted and swung her arms playfully in the air above her crib. Dr. Stephen Osburn said he felt gratified that Christina, a profoundly retarded 4-year-old, has a chance to develop, maybe even learn a few words, now that he has helped her overcome a debilitating series of illnesses.

Following revelations that doctors at Northridge Hospital Medical Center demanded cash from poor women in labor before providing a common form of anesthesia, federal health regulators have begun a sweeping audit of the hospital's practices and records.

My friend Brad was 37 when he lost his struggle with AIDS on March 13. A bright, sweet, gentle guy, he wanted to live as long as possible but was, in effect, forced by the government to agree to die in order to get the care he needed. He had been half-blind, limping around his apartment on painful legs with the aid of a walker. He was hooked up much of the time to an IV that he pulled around with him. His gaunt body was shot through with lymphoma.

A whistle-blower lawsuit by two former University of California employees alleges that the university's five medical centers--at UCLA, UC Irvine, UC San Diego, UC San Francisco and UC Davis--billed the government for millions of dollars in fraudulent insurance claims.

SANTA ROSA, Calif. – With valet parking for patients, video-conferencing for parents of premature babies and a healing garden abloom with azaleas, Santa Rosa Memorial Hospital tries to maintain the amenities of a thriving community hospital. But chief financial officer Mich Riccioni is focused on the fiscal strains Memorial is facing. Nearly a quarter of the hospital's patients are on California's Medicaid program, known as Medi-Cal, and the state has been trying for years to cut its reimbursement rates for hospitals and other healthcare providers.

Like many states, California is struggling to pay for the health insurance it offers poor residents. The ranks of the Medi-Cal program grew by more than 12% after the economy tanked, and rising healthcare costs increased the fiscal burden. Making matters worse, state officials kept trying to solve the problem mainly by paying doctors less for their services and charging Medi-Cal beneficiaries more, ignoring the skewed incentives and inefficiencies in the system that were driving costs higher.

A Ventura County commission is trying to keep secret the details of a state-ordered investigation into the management and claims procedures of a healthcare plan designed to serve the county's neediest residents. Complaints about alleged late payments and poor management prompted the Department of Health Care Services to request that auditors step in and examine the plan's financial condition and claims practices. Gold Coast Health Plan was launched last year to switch an estimated 110,000 Ventura County Medi-Cal beneficiaries into an HMO-style healthcare plan.  Previously, doctors and hospitals were free to charge Medi-Cal directly on a fee-for-service basis.

Health and Human Services Secretary Kathleen Sebelius on Sunday threw cold water on Gov. Jerry Brown's plan to ask California's poor to contribute to their federally subsidized healthcare — payments the governor has proposed to save the state more than $500 million a year. Brown met with Sebelius for 45 minutes in Washington, where he renewed his pitch for more flexibility in how the state handles Medi-Cal, its health-insurance program for the poor. The governor wants co-pays from recipients for emergency-room visits as well as routine trips to the doctor and dentist, beginning in October.

Reporting from Washington -- Gov. Jerry Brown delivered a message to the Obama administration this week in Washington: Back off. The governor wants the federal government to let him make more cuts in the Medi-Cal program that serves low-income Californians and to exempt state schools from new sanctions that could cost hundreds of millions of dollars. Brown said he raised the issues in a White House meeting with President Obama and 11 other Democratic governors Friday morning and in a private meeting with Education Secretary Arne Duncan on Thursday.

A years-long legal fight over cuts in California's multibillion-dollar healthcare program for the poor took another twist Wednesday as the U.S. Supreme Court kicked the case back to a lower court. The high court's 5-4 decision allows medical providers to continue suing to stop the cuts, which would lower reimbursement rates for doctors who participate in the state's Medi-Cal program. But it did not affirm the lower court's decision to block the reductions, leaving the state another opportunity to argue for the right to implement them to help balance its depleted budget.

In his new spending plan, Gov. Jerry Brown has proposed further cuts in state health and social programs. Some examples: $946.2 million from welfare $842.3 million from Medi-Cal $446.9 million from child care $163.8 million from in-home health aid Source: California Department of Finance

Chagrined by the estimated $1-billion Medi-Cal fraud scandal among new immigrants in their community, Armenian church and civic leaders say that an explanation may lie not in Los Angeles, where most of the crime occurred, but in the culture and politics of their homeland in the former Soviet Union. Vazken Movsesian, parish priest of St.

California and the Obama administration urged the Supreme Court this week to bar doctors and their patients from suing states over the amount paid to healthcare providers for treating Medicaid patients. Several justices seemed to agree when the case was heard Monday, noting that the federal law that created Medicaid didn't give individuals the right to sue. But that's too restrictive a view of who should have access to the courts. If states aren't meeting their obligations under the law and are effectively denying the poor access to the healthcare Medicaid was designed to provide, the public should be able to hold them accountable.

State health officials have failed to adequately or promptly review the finances of publicly funded managed-care plans responsible for serving millions of Medi-Cal recipients, according to a report released Tuesday by California's s tate auditor. The state departments of Managed Health Care and Health Care Services also didn't conduct timely medical checks, intended to ensure that Medi-Cal recipients receive high-quality care, according to the report by State Auditor Elaine M. Howle.

For more evidence that the Golden State has lost some of its luster, consider this news from the federal government: California spends less per person on healthcare than all but eight states. New data show that total spending by insurers, government agencies and individuals amounted to $6,238 per resident in 2009, well below the national average of $6,815. That puts California on a bottom tier with Arkansas, Georgia, Texas, Utah, Nevada, Arizona, Colorado and Idaho. Healthcare analysts blame the low spending largely on the fact that the state has more than 7 million people who are uninsured, or about 1 in 5 Californians.