August 2025
Recent changes in federal policy by the Centers for Medicare and Medicaid Services (CMS) redefined eligibility for Covered California to exclude DACA recipients. Over 2,300 California DACA recipients will lose their health insurance on August 31, 2025.
CMS has proposed a rule that threatens California’s longstanding Hospital Quality Assurance Fee (QAF) and Managed Care Organization (MCO) tax that supports Medi-Cal. (CAFP supported the passage of Proposition 35 to leverage the MCO tax for historic investments in chronically-underfunded Medi-Cal and primary care rates.) This rule-change would result in the loss of billions in health care funding as early as the 2025-26 state fiscal year, well before California could bring the MCO taxes into compliance.
This is in addition to the effect of the recently-passed Federal HR 1, which will cut $1 trillion from Medicaid over the next decade. States are already under immense fiscal pressure, including the loss of MCO tax revenue supporting core Medi-Cal functions and the new Prop 35 funding priorities. These losses to primary care funding may make Medi-Cal participation unaffordable for Family Physicians. AAFP has up-to date details at https://www.aafp.org/advocacy.html on changing Federal policies and funding.
HHS Secretary Robert F Kennedy Jr has dismissal all 17 members of CDC’s Advisory Committee for Immunization Practices (ACIP), a cornerstone of evidence-based immunization policy since the 1960s. Under ACIP’s support, vaccines over 6 decades eradicated polio, measles and mumps, and helped prevent millions of other infections. (Measles is already making a comeback in several states.)
The AAFP led a resolution adopted by the AMA House of Delegates calling for an end to political interference in vaccine policy; urged payers to keep COVID vaccines available and affordable for pregnant patients; reaffirmed the important role of vaccines in protecting vulnerable populations; and endorsed the Family Vaccine Protection Act (HR 3701) to protect ACIP and the National Vaccine Injury Compensation Program.
Current information on new laws & ballot propositions potentially affecting California Family Physicians is available at https://www.familydocs.org/new-laws/.
CMS has warned Medicare clinicians about a rise in phishing scams involving fraudulent fax requests for medical records. These scams use fax machines to appear more legitimate and catch practices off guard, falsely impersonating CMS and claiming the requests are related to a Medicare audit. Physicians must remain vigilant!
A Medicare data breach involved unauthorized creation of Medicare.gov accounts, using personal information from unknown external sources. CMS notified over 100,000 Medicare beneficiaries, and has deactivated affected accounts and launched an investigation. Everyone including the elderly needs to stay alert for evidence of online piracy!
