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December 7, 2005 - Chapter 794, Statutes of 2002 (AB 1401, Thomson), directed the Legislative Analyst’s Office (LAO) to evaluate the effectiveness of the measure in providing heath care coverage to individuals who are otherwise unable to obtain health benefits (the "hard-to-insure"). While we found there is now only limited information available to assess the outcome of various aspects of AB 1401, we concluded the measure has increased the state’s capacity to help hard-to-insure individuals access health coverage using the same level of state resources. Based upon our evaluation, we present several recommendations to improve the program by potentially reducing its costs to enrollees and the state.
November 16, 2005 - Presented to Budget Subcommittee #1 on Health and Human Services
November 16, 2005 - Presented to the Budget Subcommittee #1 on Health and Human Services
November 2, 2005 - Presented to the Assembly Budget Subcommittee No.1 on Health and Human Services
August 16, 2005 - We identify the differences between the projections of Medi-Cal Program expenditures recently released by the Public Policy Institute of California (PPIC) and those prepared by our office, and shed light on the reasons for those differences.
March 15, 2005 - The Medicare Prescription Drug, Improvement and Modernization Act, also referred to as the Medicare Modernization Act (MMA) makes significant changes to the federal Medicare program. The implementation of the Medicare drug benefit component of MMA, known as Part D, is likely to cause significant net financial losses to the state for years and have other major programmatic impacts on Medi-Cal. We recommend some limited actions and strategies the Legislature can take to address these potential problems.
February 24, 2005 - We recommend the Legislature approve the Governor’s budget proposal for Proposition 99-funded programs, which shifts allocations of tobacco tax revenues to maximize resources for health programs and achieve General Fund savings. We further recommend that the Legislature begin this year to address the long-term issues posed by the present structure of Proposition 99.
February 24, 2005 - Our analysis finds that the way the state sets rates for vendors who provide community services for the developmentally disabled on the whole lacks a rational and consistent approach. We review how rates are set for these services and offer an improved and systematic approach that could achieve significant state savings.
February 24, 2005 - The state’s hospital system continues to face a variety of fiscal challenges that weigh particularly heavily on public hospitals. The administration is negotiating with the federal government for a comprehensive redesign of hospital financing as part of its Medi-Cal redesign package. Our review of the plan now under development suggests that it could help preserve the financial stability of public hospitals but also raises some significant fiscal and policy issues.
February 24, 2005 - The seven-part administration redesign proposal would result in broad changes in Medi-Cal managed care as well as some more limited changes in benefits, cost-sharing, and eligibility administration. Overall, we find that the Governor’s proposals are conceptually sound but that the Legislature needs more information about some aspects of the package and that some refinements are warranted.
February 24, 2005 - The state lacks a unified strategic approach to homeland security. The Office of Homeland Security and the Department of Health Services have not sufficiently coordinated their efforts. We make a number of recommendations to address these problems, including the development of a strategic plan and annual expenditure report.
February 17, 2005 - State agencies purchase about $4.2 billion annually in prescription and nonprescription drugs as part of their responsibilities to deliver health care services to their program recipients. Our review—which focused on 10 percent of these purchases—found several deficiencies in the state's procurement of drugs which lead to it paying higher costs than necessary. We make a number of recommendations to correct these procurement and administrative deficiencies which would, if implemented, generate savings totaling tens of millions of dollars annually.
February 10, 2005 -
Our analysis indicates that the Governor's California Rx plan for drug discounts for the uninsured provides a reasonable starting point for the development of such a program. However, we propose, among other changes, that in the event that drug makers fail to make good on their promises for significant price concessions, an automatic trigger would phase-out the proposed voluntary approach to obtaining rebates from drug manufacturers, and be replaced by an alternative strategy likely to result in greater discounts on more drugs for consumers.
A related report—Lowering the State's Costs For Prescription Drugs—which addresses the state's purchasing of drugs for its own programs, will be released shortly.