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February 23, 2006 - Medi-Cal’s lack of accurate information about the prices of prescription drugs means that the program is reimbursing pharmacies much more than appears to be reasonable. We recommend legislation to ensure that reimbursement for drugs is set at more appropriate levels.
February 23, 2006 - An increasing portion of long-term care spending is for community-based services rather than institutional care. We examine the “cost-drivers” behind the growth in these costs and recommend that administration budget requests for long-term care projects be modified.
February 23, 2006 - A new federal hospital financing waiver is estimated to result in a net increase in Medi-Cal costs of $39 million over its first two years. We recommend that the waiver instead be implemented in a manner that avoids these costs and generates significant state savings.
February 23, 2006 - Future uncertainty about reauthorization of federal funding and the eventual exhaustion of unspent federal funds pose a risk of significant future increases in state costs for the Healthy Families Program (HFP). We present alternatives to hold down increases in overall HFP costs and to obtain additional financial support for the program.
February 23, 2006 - Spending for some specific services and supports for persons with developmental disabilities varies so widely among regional centers (RCs) as to raise concerns about the fiscal controls over these expenditures. We recommend an audit to evaluate the situation.
February 23, 2006 - The Legislature should take steps to deter costly nonemergency visits to emergency rooms (ERs) and to improve access to care and quality of care in community settings. This should be accomplished by establishing effective copayments on the inappropriate use of ERs and by seeking available federal funds to improve access to primary care.
February 23, 2006 - We review the state’s response to problems in the rollout of the new federal Medicare Part D prescription drug benefit and recommend Medi-Cal reductions of almost $335 million over two years to adjust for this rapidly changing situation.
February 22, 2006 - State costs for reimbursing counties for two state-mandated programs to provide mental health services for school children have grown significantly in recent years. Moreover, serious weaknesses are evident in the system for delivering these services for children in special education programs. To help guide legislative policy-making in this area, we provide background information on these two mandates, assess the Governor’s budget and policy proposals relating to them, and outline the Legislature’s options for addressing these issues.
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.