Department of Health Care Services
Medi-Cal


CURRENT YEAR
 The May Revision reflects total Medi-Cal expenditures of $35.4 billion ($13.6 billion General Fund), a decrease of $85.8 million ($20.7 million General Fund) from the Governor's Budget. General Fund expenditures for Medi-Cal have increased by $797.5 million, or 6.2 percent over the 2005-06 level.

The average monthly Medi-Cal caseload is expected to decrease by 59,500 beneficiaries, to 6,534,600 eligibles, which is a decrease of 0.9 percent from the level projected in the Governor's Budget. The revised caseload is 0.6 percent lower than the 2005-06 caseload.

The net General Fund decrease from the Governor's Budget level includes the following significant adjustments:

  • $92 million increase to repay the federal government for non-institutional provider over-payments discovered when recording paid claims that had been audited and identified as erroneous due to miscoding of services, claiming errors, or provider errors.
  • $30.5 million increase resulting from a continued delay in federal approval of the State Plan Amendment (SPA) allowing the separation of physician and non-physician costs from certified eligible expenditures under the Hospital Financing Waiver. Approval of the SPA was anticipated in 2006. This would have shifted funding for designated public hospitals to 100 percent federal funding and provided a corresponding recoupment of state funds in the current year. Recoupment is now anticipated in 2007-08.
  • $63.5 million decrease resulting from the Medi-Cal dental fiscal intermediary's repayment of premium costs that exceeded audited expenditures, which were much lower than anticipated due to statutory restrictions on covered benefits and more stringent authorization requirements.
  • $51.9 million decrease in anticipated capitation payments to County Organized Health Systems due to identification of persons dually eligible for Medi-Cal and Medicare and the impact of federal Medicare Part D Pharmacy benefits. When persons are dually eligible, Medi-Cal pays only for services not covered under Medicare.
  • $27.1 million decrease in the amount previously estimated to be repaid to the federal government for the federal share of non-emergency services provided to qualified aliens who have been in the country for less than five years, based upon revised data.
  • $21.7 million decrease in county and other administration costs due to lower caseload growth, the final reconciliation of county administrative costs for 2004-05, and a delay in county billing for outreach costs.

BUDGET YEAR
 The May Revision includes total Medi-Cal expenditures of $37.7 billion ($14.7 billion General Fund), a net total funds increase of $330.3 million ($39.4 million General Fund) from the Governor's Budget. General Fund expenditures are expected to increase by $1.1 billion, or 7.6 percent over the revised 2006-07 level.

The average monthly Medi-Cal caseload is expected to decrease from the Governor's Budget by 98,600 beneficiaries, or 1.5 percent, to 6,602,900 eligibles.

The net General Fund increase from the Governor's Budget level includes the following significant adjustments:

  • $107.1 million increase for implementation of new rates for all Medi-Cal managed care plans based on the plan-specific, experience-based rate methodology developed as a result of a recent study.
  • $39.4 million increase in county and other administration costs due to an update of base costs and funding for the one-time and ongoing costs for implementation of federal Deficit Reduction Act (DRA) citizenship verification requirements.
  • $20.0 million increase in the Medi-Cal Minor Consent program due to loss of federal financial participation for a portion of the program. To protect the ability of minors to access pregnancy services, the state will not enforce DRA citizenship and identification requirements for minors independently seeking services.
  • $34.2 million decrease in the amount previously budgeted to be repaid to the federal government for the federal share of non-emergency services provided to qualified aliens who have been in the country for less than five years, based upon revised data.
  • $30.5 million decrease for anticipated repayments from designated public hospitals that were expected in 2006-07 but are now delayed until early 2007-08 when the State Plan Amendment is expected to be approved.
  • $26.1 million decrease in anticipated capitation payments to County Organized Health Systems mainly due to identification of persons dually eligible for Medi-Cal and Medicare and the impact of federal Medicare Part D Pharmacy benefits. When persons are dually eligible, Medi-Cal pays only for services not covered under Medicare.
  • $10.6 million decrease in the Medically Indigent Adult Long-Term Care program resulting from a $10.6 million increase in federal funds through the Safety Net Care Pool portion of the hospital financing waiver. This fund shift will allow the state to maximize available federal funding for public hospitals as authorized under the hospital financing waiver.
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CHAPTER HIGHLIGHTS for Health and Human Services Back to Top

 May Revision Adjustments-Highlights
 Department of Alcohol and Drug Programs
 Department of Health Care Services
 image of black pointing arrowMedi-Cal
  Family Health Estimates
 Department of Public Health
 Managed Risk Medical Insurance Board
 Department of Developmental Services
 Department of Mental Health
 Department of Social Services
PRINTABLE BUDGET DOCUMENTS Back to Top
Revised Budget Summary - Health and Human Services (pdf * - 42K) -
Provides the entire Health and Human Services Chapter in pdf format.
ADDITIONAL INFORMATION Back to Top
Revised Budget Detail - Health and Human Services
Displays Revised Budget Detail information for Health and Human Services.

Proposed Budget Summary - Health and Human Services (January 2007)
Displays Proposed Budget Summary information for Health and Human Services.