CHA Blog

The Senate Special Committee on Aging will hold a hearing on Older Americans Act (OAA) reauthorization this Thursday, May 26, at 2 p.m. Eastern Time. The hearing will explore recommendations for strengthening and improving OAA programs, including testimony from Assistant Secretary for Aging Kathy Greenlee, former First Lady Rosalynn Carter, and Max Richtman, chair of the Leadership Council of Aging Organizations (LCAO). The hearing will be webcast live on May 26. See the Senate Special Committee on Aging webpage for the webcast.

Since passed by Congress in 1965, the OAA has funded numerous essential social and nutritional services that keep seniors independent, in their homes and in their communities. Some of these services include: meals, job training, senior centers, caregiver support, benefits enrollment, transportation and more.

See the Administration on Aging website for more details on the OAA. The National Council on Aging website also has many resources on the OAA, including a webinar on the history and promise of the OAA.

Starting June 2011, California’s Department of Health Care Services (DHCS) is requiring people with disabilities and seniors who have Medi-Cal only (not Medicare) to enroll in a Medi-Cal managed care plan.  DHCS has worked with the California HealthCare Foundation and the Center for Health Care Strategies to coordinate a 90-minute informational webinar to provide information about the upcoming change to advocates and organizations that serve seniors and people with disabilities.  Three sessions have already been held and 2 more will be held on Wed. May 25th. One session is from 10 – 11:30 a.m. and the other is from 12:30 -2 p.m.

Sign up as space is limited. Register for the Medi-Cal Informational Webinar online.

This change will affect the following 16 California counties: Alameda, Contra Costa, Fresno, Kern, Kings, Los Angeles, Madera, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, San Joaquin, Santa Clara, Stanislaus and Tulare.

More info on this change will be posted soon.

It’s been a while since we’ve talked about the Limited Income Newly Eligible Transition (LI NET) program for Part D coverage and the Best Available Evidence (BAE) policy, and sometimes people get these confused.

To clarify, LI NET is a  ”safety net” Part D prescription drug coverage for low-income subsidy (LIS) eligible beneficiaries who are NOT currently enrolled in a Part D plan. The Best Available Evidence policy, however, is for people who ARE enrolled in a Part D plan, and is used when a person’s plan does not know s/he is LIS eligible. In these situations, instead of putting the burden of providing “official” proof of LIS eligibility on the beneficiary, the BAE policy allows for the beneficiary to show minimal evidence and therefore receive their prescriptions at the lower subsidized cost.

For more information on LI NET, see the Centers for Mediare and Medicaid Services’ (CMS) recent LI NET update (PDF).

For more information on the Best Available Evidence policy, see our BAE article.

Bonnie Burns, our Training and Policy Specialist, Stephen Finan and several other advocates serving as consumer representatives with the National Association of Insurance Commissioners (NAIC) co-authured an article urging the NAIC not to endorse legislation that would remove broker and agent commissions from the medical loss ratio (MLR). This is a calculation that has the potential of giving consumers valuable insights about the proportion of their premiums spent on health care costs and improving quality of care compared with administrative expenses, including high salaries and bonuses. The health care reform law requires that 80-to-85% of the money collected by insurance companies be spent on health care services and health care quality improvement. Insurance companies have until next year to comply with this requirement.

Burns and other advocates voice their concern that removing broker and agent commissions would skew the accuracy of this ratio. It would have far-reaching implications for the reliability of the MLR as a measure of a health plan’s value, for the broader goal of improving quality and controlling costs, and for the NAIC itself.

Read the article, “For the NAIC, A Consequential Decision on the MLR (Guest Opinion)“ for more details.

Also see the Healthcare.gov website for more information on the MLR.