The 2018-19 Budget: Analysis of the Governor's 340B Medi-Cal Proposal

Mar 21, 2018 - The dollar amounts listed represent hypothetical payment amounts. In the simplest Medi ‑Cal FFS arrangement, a covered entity, such as a public hospital, would purchase a prescription drug at its 340B price ($1 0) d irectly from a drug manufacturer.
https://lao.ca.gov/Publications/Report/3790

The 2019-20 Budget: Analysis of the Carve Out of Medi-Cal Pharmacy Services From Managed Care

Apr 5, 2019 - As previously discussed, DHCS has a preferred drug list that steers utilization toward preferred drugs within Medi ‑Cal FFS. In exchange for placement on DHCS ’s preferred drug list, drug manufacturers offer supplemental rebates to the state, which are rebates on top of the federal rebates that lower the preferred drugs ’ final price below the best price available under the federal rebates.
https://lao.ca.gov/Publications/Report/3997

The 2025-26 Budget: Medi-Cal Pharmacy Spending

Apr 3, 2025 - To induce participation, California leverages its negotiating power by including drugs with supplemental rebates in its preferred drug list. State supplemental rebates historically have comprised just a fraction of the overall savings from Medi ‑Cal rebates.
https://lao.ca.gov/Publications/Report/5026

The 2026-27 Budget: Department of Developmental Services

Mar 13, 2026 - The department stated that its budget projections for 2026 ‑27 do not incorporate any potential added costs due to the changes in H.R 1. Will the department be able to determine whether its costs increase in the future due to H.R. 1?
https://lao.ca.gov/Publications/Report/5157

The 2025-26 California Spending Plan: Health

Oct 16, 2025 - To maintain licensure, these entities must (1)  act in a payor ’s best interests; (2)  submit financial statements to DMHC; and (3)  submit drug pricing data to HCAI, among other requirements. Pharmacy benefit managers are to pay annual fees to support DMHC ’s and HCAI ’s ongoing regulatory costs.
https://lao.ca.gov/Publications/Report/5075

Building California’s Behavioral Health Infrastructure: Progress Update and Opportunities for the Proposition 1 Bond

Feb 5, 2025 - Strategies to do so have included expanding the behavioral health workforce; adding benefits and increasing rates in Medi ‑Cal; and increasing capacity through managed care plans, schools, and in other  settings.
https://lao.ca.gov/Publications/Report/4954

The 2025-26 Budget: Health Care Access and Information

Feb 20, 2025 - Historically, prescription drug prices have tended to grow faster than prices for overall consumer goods and services. As Figure  5 shows, however, as measured by the consumer price index, prescription drug cost inflation has slowed over the past 50 years.
https://lao.ca.gov/Publications/Report/4979

The 2026-27 Budget: Medi-Cal Analysis

Mar 2, 2026 - One possible reason for our higher estimate is that our model reflects not only disenrollment among current enrollees, but also reduced enrollment flows over time and a persistent risk of disenrollment among eligible individuals due to added administrative burden.
https://lao.ca.gov/Publications/Report/5146

Considering Medi-Cal in the Midst of a Changing Fiscal and Policy Landscape

Oct 24, 2025 - …But Potentially With Added Complexity. Adding more flexibilities also could come with the potential downside of more complexity for beneficiaries and counties. For example, exempting high unemployment counties from work requirements could create more volatility.
https://lao.ca.gov/Publications/Report/5083

The 2025-26 Budget: CalAIM Enhanced Care Management and Community Supports Implementation Update

Mar 6, 2025 - The difficulty MCPs have in adding ECM and Community Supports providers may be keeping utilization rates lower than expected. Systemic Constraints Limit Utilization. Lower ‑than ‑expected utilization of certain benefits may be driven more by systemic constraints across different regions of the state rather than a low demand for those benefits.
https://lao.ca.gov/Publications/Report/5003