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Michael Hunn left the clergy and became a hospital and health system executive. He’s been named CEO of CalOptima, Orange County’s Medi-Cal health insurance plan for low-income residents, and his spiritual background is helping him guide the publicly run plan into the future.
The company awarded the state’s Medi-Cal Rx contract was taken over by another company, Centene. That left the state with a contractor it didn’t pick — one that has been accused of overbilling nine other state Medicaid programs and is now under investigation by California.
California regulators issued record fines against L.A. Care, the state’s largest Medi-Cal managed-care plan, for providing inadequate care to its enrollees. But whether the penalties are a sign that the state will make a more forceful effort to improve Medi-Cal’s overall quality of care remains to be seen.
California was supposed to start paying doulas this year to help Medicaid enrollees have healthy pregnancies. But the benefit has been delayed because doulas feel lowballed by the state’s proposed reimbursement rate, which is below what most other states pay.
KHN senior correspondents Jenny Gold and Anna Maria Barry-Jester joined KVPR’s Kathleen Schock on “Valley Edition” to discuss their investigation into the abrupt closure of one of California’s largest chain of pain clinics — and the patients left behind.
After a troubled start to the new Medi-Cal prescription drug program, the state’s contractor has hired staffers to reduce wait times for medication approvals and patients seeking help. But some doctors and clinics report that patients continue to face delays.
In May 2021, Lags Medical Centers, one of California’s largest chains of pain clinics, abruptly closed its doors amid a cloaked state investigation. Nine months later, patients are still in the dark about what happened with their care and to their bodies.
KHN and California Healthline staff made the rounds on national and local media this week to discuss their stories. Here’s a collection of their appearances.
Problems with California’s new Medicaid prescription drug program are preventing thousands of patients from getting their medications, including some life-saving ones. State officials say they’re working on fixes.
The backroom deal with politically connected Kaiser Permanente, which infuriated other Medi-Cal health plans, allows the health care giant to continue selecting the enrollees it wants.
On Jan. 1, California started buying prescription drugs for its nearly 14 million Medicaid enrollees, a responsibility that had primarily been held by managed-care insurance plans. State officials estimate California will save hundreds of millions of dollars by flexing its purchasing power, but some health clinics expect to lose money.
Many of the 14 million patients in Medi-Cal are in managed care health plans that outsource their care to subcontractors or sub-subcontractors. For patients with difficult health care needs, it can be hard to know where to turn.
In January, California’s Medicaid program will begin offering nontraditional services —such as ridding homes of roaches, replacing mattresses and installing air purifiers — to some low-income asthma patients. But the rollout could be chaotic, with insurance companies struggling to identify groups that can deliver the services.
While other states dramatically restrict abortion and the conservative-leaning U.S. Supreme Court weighs Roe v. Wade, California is preparing to absorb the country’s abortion patients.
The nine commercial insurers in Medi-Cal must reapply by submitting bids for new contracts. The state hopes the process will improve care for low-income residents and tighten accountability, something critics say has been missing.
A class action lawsuit seeks better care for immigrants with physical disabilities or mental illness who were detained after trying to enter the country. Other disabled immigrants without legal status are also finding it difficult to get care.
If Gov. Gavin Newsom survives Tuesday’s recall election, the health care unions that have campaigned on his behalf intend to pressure him to follow through on his promise to establish a government-run health system in California.
Those seeking to replace California Gov. Gavin Newsom in Tuesday’s recall election disagree with him on more than mask and vaccine mandates. The conservative candidates tend to favor free-market solutions over Newsom’s expansion of publicly funded health coverage.
California is embarking on a five-year experiment to infuse its health insurance program for low-income people with billions of dollars in nonmedical services spanning housing, food delivery and addiction care. Gov. Gavin Newsom said the goal is to improve care for the program’s sickest and costliest members and save money, but will it work?
Efforts by states and the private health plans that many states pay to cover low-income Americans has been scattershot and hampered by a lack of data.
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