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State and County to Sell Federal Officials On New Health Pact

State and County to Sell Federal Officials On New Health Pact

Now comes the hard part.

After grinding out an agreement last week aimed at saving L.A. County’s troubled health system, state and county officials must now sell the plan to the Bush Administration.

The three sides expect to meet Dec. 9 and 10 in Washington to work out the details of the plan, which state officials contend meets broad guidelines previously set out by federal officials but still includes some thorny issues.

The complex agreement is expected to net the county roughly $700 million in additional federal funds over the next five years, preventing the closure of any major public hospitals.

But a key part of the plan is predicated on federal and state officials resolving an ongoing dispute about what California deserves under the Selective Provider Contracting Program.

The federal program allows the state to keep hundreds of millions of dollars in savings generated by providing federal Medicaid dollars through managed care contracts, instead of traditional fee-for-service arrangements.

However, federal and state officials have been at odds for months over just how much of the savings California is due and the plan envisions L.A. County receiving $300 million from the program.

Also tricky will be a state and county proposal to allow Los Angeles County to continue to draw down federal Medicaid dollars, which generally favor inpatient care, even when patients are transferred to outpatient clinics.

However, state officials maintain that all elements of the agreement, which had been worked on for months, were either suggested directly by Bush Administration officials or have been approved as waivers of federal laws in at least one other state.

Laurence Darmiento

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