(CMA Alert, April 6, 2015 issue)
New study finds thousands may be eligible for health insurance in California under DACA Between 360,000 and 500,000 immigrants living in California could become eligible for Medi-Cal if they receive temporary protection from deportation through President Obama’s Deferred Action for Childhood Arrivals (DACA) program, according to a study by UC Berkeley’s Center for Labor Research and Education and the UCLA Center for Health Policy Research. Under the President’s executive actions on immigration, those people living in the U.S. without permission can’t enroll in Covered California, but the state does allow those granted temporary relief from deportation to sign up for Medi-Cal. That means up to half a million more people could apply for the state’s low-income health program. In November, Obama announced the expansion of DACA, which was established in
2012, and the creation of Deferred Action for Parents of U.S. Citizens and Lawful Permanent Residents (DAPA). Application processes for the new programs have been placed on hold under a court order, but immigration policy experts predict that the new programs will ultimately be implemented. The study also comes as the California Legislature considers the Health for All Act, or SB 4, proposed by state Senator Ricardo Lara. The bill would expand eligibility for comprehensive Medi-Cal to all low-income Californians, regardless of their immigration status, and broaden undocumented Californians’ options for purchasing private insurance. The study’s authors estimate that 66% of adults who would be eligible for Medi-Cal are working. The researchers also found that Califor-
(CMA Alert, March 23, 2015 issue)
nians eligible for the program are relatively young: 92% are under the age of 45, which would likely mean that their insurance premiums would be lower than the current statewide average. Providing comprehensive coverage would also build upon federal and state funds already spent. Previous research by the authors found that 60% of the cost per adult of comprehensive Medi-Cal coverage is already paid for by the federal and state government through restricted scope Medi-Cal, which covers emergency and pregnancy-related services. The health coverage and demographic estimates use data from the 2013 Current Population Survey, conducted by the U.S. Bureau of Labor Statistics and Census Bureau. The estimates are applied to the Pew Research Center’s estimate that 1.25 million Californians are potentially eligible for DACA and DAPA.
(CMA Alert, March 23, 2015 issue)
Raising the smoking age DWC implements annual to 21 could reduce tobacco changes to workers’ use among next generation compensation physician fee schedule
A report released March 12, 2015, by the Institute of Medicine (IOM) said that raising the smoking age to 21 could reduce smoking by as much as 12% in the next generation. In addition, smoking-related deaths could be cut by nearly 10%. Tobacco use remains the leading cause of preventable death in this country. The U.S. Surgeon General estimates that 5.6 million youth alive today will lose their lives prematurely if we don’t do more to reduce current smoking rates. Roughly 90% of daily smokers first tried a cigarette before age 19, a time when researchers say the brain is still developing in areas like decision-making and impulse control. That development continues until about age 25. In California, a bill to raise the minimum smoking age from 18 to 21 has been introduced in the state legislature. Senate Bill 151, introduced by Senator Ed Hernandez, would make California the first state in the country to raise the minimum smoking age as high as 21. Similar proposals have previously failed in New Jersey, Utah, Colorado, and Maryland. The California Medical Association supports the legislation. The IOM’s 335-page report, Public Health Implications of Raising the Minimum Age of Legal Access to Tobacco Products, outlines the likely effects of setting the minimum age at 19, 21, and 25 years.
The California Division of Workers’ Compensation (DWC) has implemented its annual adjustments to the California workers’ compensation resource-based relative value scale (RBRVS) fee schedule effective for dates of service on or after March 1, 2015. Under the RBRVS Physician Fee Schedule regulations, located under “Physician services” on DWC’s Official Medical Fee Schedule (OMFS) webpage, the calculations to determine maximum allowable amounts for each code incorporate a number of factors, including the assigned relative value units for each code along with the yearly adjusted conversion factor determined by DWC. DWC updates these factors annually respective of changes in the Medicare payment system. DWC has reiterated that will not be publishing a composite fee schedule for physicians to access. Physicians seeking a streamlined method of determining correct reimbursement amounts for workers’ compensation medical services can contact DaisyBill, which offers an easy-to-use OMFS Calculator (http://www.daisybill.com/calculator-features).
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