[{"_1":2,"_100":-5,"_101":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76,88],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},"mediaId",6155778,"mediaKeyId","5473618-4dad7aa41e1104a45fada95773200303","parentId",5473618,"title","Regents briefed on federal Medicaid cuts in final reconciliation law and potential impacts on UC Health","audioSeconds",1873,"startMs",4973000,"endMs",6846000,"viewUrl","/Search/View?dp=1&key=5473618-4dad7aa41e1104a45fada95773200303&start=4973&end=6846","thumbnailUrl","https://assets.pipeline.soar.com/5473618-4dad7aa41e1104a45fada95773200303/thumbnail_4973000.jpg","articleUrl","/articles/6155778/California/Regents-briefed-on-federal-Medicaid-cuts-in-final-reconciliation-law-and-potential-impacts-on-UC-Health","mediaUrl","https://secure.pipeline.soar.com/6155778-d096a122514d4350c7c23a1c242ccfa2/orig.mp4?Expires=1770744282&Signature=P0alMuw8Ub-0oGIkiHTWjA8Hb6INSdxMaXqf~gMs8a5hj6mft-rOZl~3-1eK~UXTiAIufXGhN4giWdmwg-~5kB2fP3hjfpTvtNNkWZojV1k5CwIU5ff5p1vsNS-wfksotA6IHP-fwCQrFsBZpvNzuo8enoVxngH3ngtQKV5wYfx1epwxp8GRyXbUgFmNHVWOHtFuJZ8BixoNRaukLHhk5VTQGoaWbzWQyqazr6YdtedS73YaqQXNiBqM9aSsgnD7IvrT7k8FqJhznNImYEzbz~q3mQwsI4DgtmtzWqDcnL6aRg0MjJge-jlmsW2~ZvhbvsVt6fDx~YfP4SKROHBsHA__&Key-Pair-Id=KUT5TJCACFTXG","author","University of California","date","2025-07-13T00:00:00Z","article","University of California federal and health policy staff told the Health Services Committee that the federal reconciliation law signed July 4 makes the single largest cut to Medicaid in history and will materially affect UC Health and California hospitals through multiple mechanisms, including freezing and phasing down state-directed payments, changing provider tax rules and imposing new eligibility and reporting requirements.

“[The reconciliation bill] makes the largest cut to Medicaid in history by cutting spent Medicaid spending by a trillion dollars over a decade,” Tam Maher, AVP of Health Policy and Regulatory Affairs, said during the federal policy update. Kent Springfield, director of health and clinical affairs in federal government relations, described UC advocacy efforts in the preceding months to educate members of Congress and oppose proposals that would have worsened the impact.

Why it matters: UC hospitals rely heavily on Medi‑Cal supplemental and directed payments and on certain state provider taxes to finance services for Medi‑Cal patients. Presenters said supplemental payments comprise a substantial share of hospital Medi‑Cal reimbursements and that changes in federal rules and matching rates will shift costs to the state and to providers.

Major provisions described
- State-directed payments: The law freezes existing state-directed payments and, beginning in 2028, phases down the ceiling for those payments from an average commercial rate to Medicare levels, reducing supplemental payments over several years. UC staff estimated an illustrative cumulative reduction across UCHealth of roughly $100 million, subject to change as federal guidance is released.
- Provider taxes: The law tightens rules for permissible provider taxes and barred new or increased provider taxes after enactment. California’s managed care organization (MCO) tax and private hospital tax were flagged as potentially noncompliant under the new standards. Staff said invalidation of an existing MCO tax could create an estimated multi‑billion-dollar hole in the state budget (~$4 billion cited for the state) and threaten funding streams accessed by UC and public hospitals.
- Match rate for emergency Medicaid services for non‑citizens: Federal matching for emergency services for certain non‑qualified immigrants would fall from 90% to 50%; UC staff estimated a preliminary $30 million system impact, with uncertainty depending on enrollment and service patterns.
- Eligibility and enrollment: The bill requires community-engagement (“work”) requirements (80 hours monthly) and more frequent eligibility verification, plus new cost-sharing up to $35 per service (with several exceptions). Presenters warned these administrative and reporting rules could cause eligible people to lose coverage and increase uncompensated or emergency care use.

System and state response
UC’s federal relations and campus government relations directors led an advocacy campaign that included letters, meetings and constituent outreach; presenters thanked members of the California delegation who raised concerns in process. The law’s implementation is staggered: some provisions took effect immediately on enactment (e.g., provider tax freeze), others phase in 2026–2028. Staff said they will monitor federal rulemaking and CMS guidance, press for transition periods and delays where feasible, and engage with the state as it adapts its budget and Medicaid financing.

Regents’ concerns and next steps
Regents asked about timeline and potential scale of coverage loss. Staff said statewide estimates range into the low millions of people losing coverage over time; direct UC patient counts were not provided. Multiple regents asked for a follow-up briefing focused on state impacts and on the provider tax and MCO tax issues. Staff said they and trade associations (AAMC and others) will continue advocacy and that administrative guidance from CMS will shape outcomes.

Ending: The committee asked staff to remain engaged with federal and state policymakers, to seek delays or transition periods where possible, and to provide additional briefings as federal and state implementation details emerge.","mediaType","Video","parentTitle","Health Services Committee","oneSentenceSummary","University of California federal and health policy staff told the Health Services Committee that the federal reconciliation law signed July 4 makes the single largest cut to Medicaid in history and will materially affect UC Health and California hospitals through multiple mechanisms, including freezing and phasing down state-directed payments, changing provider tax rules and imposing new eligibility and reporting requirements.","taxTitle","University of California, Boards and Commissions, Executive, California","taxId",76757,"location","California","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6155783,"UC Health leaders outline rising drug costs, urge exploring a UC-run PBM",2956,643000,3599000,"/Search/View?dp=1&key=5473618-4dad7aa41e1104a45fada95773200303&start=643&end=3599","https://assets.pipeline.soar.com/5473618-4dad7aa41e1104a45fada95773200303/thumbnail_643000.jpg","/articles/6155783/California/UC-Health-leaders-outline-rising-drug-costs-urge-exploring-a-UC-run-PBM","https://secure.pipeline.soar.com/6155783-f0b0c044a6a4e983d47baf8c180dc78d/orig.mp4?Expires=1770744282&Signature=fQ3YF0VIDVCb8Xyq6ubND4S60ISFur84G0fR9BHdrL3j2M3gWf7sxPN6TeFhtMfiUUM9RIZ5i47Y2O8WarWULiR3nCAfCzuvJ7U92pXETx0wKVTTKm7hLvKuhyV75yKQpetSYUnsxSyM33qZ1TyGKxS7UFhzHPc7~A1uR55j4uovQP50VAN6wuLSa2dvqKD8Hljb9N46ac7d-6CBOJXfkAAbivQxq4M3KNL4UwasWsMjnSJHrgBLEiP1ehhujo~yA4VW3nhRCJaHTQMVa0H4~dvK12q1JAAKM5FIrjlLJu-tqANRQnOCJo4z3hNEAzuF7yNV8J-HRST6G-agH98ryQ__&Key-Pair-Id=KUT5TJCACFTXG","UC Health pharmacy leaders told the Health Services Committee that rapidly rising pharmaceutical costs — especially for one-time curative gene and cellular therapies delivered in outpatient settings — are driving a growing share of system expenses and warrant system-level strategy, including exploring a UC-run pharmacy benefit manager.

The presentation on UC medical center pharmacy operations described national and system trends and urged continued advocacy, systemwide clinical coordination and further study of a transparent PBM approach. “There are roughly 2,000,000 unique patients that we take care of every year, about 9,000,000 outpatient visits across the system,” Chad Hatfield, chief pharmacy officer at UC Davis Health, said. “From an operating expenditure, we're sitting about $21,000,000,000 of pharmacy sits around 2.6” percent of operating expense as a stand-alone drug-expenditure line, Hatfield said.

Why it matters: Presenters said the largest drivers are (1) the rise of high-cost curative therapies (gene and cell therapies that can cost millions per course), (2) migration of treatments from inpatient to ambulatory settings (infusion centers, specialty retail), and (3) complex third‑party contracting through pharmacy benefit managers that limits price transparency and captured rebates. Dave Rubin, executive vice president, framed PBM discussions as part of a broader strategy to align UC’s negotiating leverage with payers and manufacturers.

Key facts and system response
- A UC example presented: clinicians used a curative gene therapy for a pair of pediatric patients that dramatically improved mobility; Hatfield used that case to illustrate clinical benefit alongside high cost. He said some new therapies now price in the millions compared with six‑figure single‑drug prices a decade ago.
- UC system pharmacy spend has grown year-to-year; presenters attributed part of the increase to acquisitions adding sites and part to pure price inflation. Hatfield said roughly two-thirds of drug spend is in ambulatory care.
- UC maintains formulary and clinical review structures (local pharmacy and therapeutics committees and a system-level high-impact council) and leverages the 340B program and other mitigation strategies, which have generated multi‑hundreds of millions in savings in recent years, presenters said.

PBM opportunity and next steps
Presenters described a “transparent PBM” or a UC-managed PBM as a possible route to retain rebates and manage formularies closely with academic clinicians. Mike Goode, an external advisor, reported that his institution created an internal PBM and saw an immediate rebate recovery (about 8% on $35 million in spend in his example) that previously went to opaque intermediaries. “If we can do that at a small school, the power of the UC system, a PBM driven by the UC system should really bring a pharmaceutical savings,” Goode said.

Committee members pressed staff on implementation scope and sequencing: whether a UC PBM would start with employee health plans, then expand to public or commercial lives, and what governance and vendor, plan, and clinical partnerships would be required. Cedric Terrell and other pharmacy leaders said they would return with a concrete implementation plan and resource estimate; Cedric agreed to bring back details in upcoming meetings.

Policy and state interaction
Presenters flagged the Office of Health Care Affordability (OHCA) growth targets in California and said UC is engaged with state policy makers to ensure novel therapies and venue-of-care distinctions are considered in affordability rules. They also discussed opportunities with state purchasing and wholesaler contracts and noted potential “lockouts” by some PBMs or retail chains that can prevent UC pharmacies from dispensing certain medicines for patients.

Quotes and attribution follow the meeting transcript and Q&A. The discussion was advisory; no committee motions or votes were taken on policy changes. Staff were directed to return with a detailed PBM option paper, including proposed pilot populations, resource needs, and estimated savings.

Ending: Regents signaled support for further study and asked staff to return with a specific plan and timeline. Presenters recommended continued system advocacy on drug affordability, preserving 340B and other mitigation programs, and leveraging UC clinical expertise in any PBM design.","UC Health pharmacy leaders told Regents the system faces rapid growth in drug spending driven by curative gene and cellular therapies and outpatient care, and recommended pursuing a transparent pharmacy benefit manager (PBM) strategy and continued engagement with state affordability regulators.",{"_33":89,"_35":36,"_37":38,"_39":90,"_41":91,"_43":92,"_45":93,"_47":94,"_49":95,"_51":96,"_53":97,"_55":56,"_57":58,"_59":98,"_61":62,"_63":64,"_65":99,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6155774,"Medical-school leaders brief Regents on LCME standards and faculty governance for curriculum oversight",2291,3598000,5889000,"/Search/View?dp=1&key=5473618-4dad7aa41e1104a45fada95773200303&start=3598&end=5889","https://assets.pipeline.soar.com/5473618-4dad7aa41e1104a45fada95773200303/thumbnail_3598000.jpg","/articles/6155774/California/Medical-school-leaders-brief-Regents-on-LCME-standards-and-faculty-governance-for-curriculum-oversight","https://secure.pipeline.soar.com/6155774-3c93dfd95b5a44e84194a5ec75677080/orig.mp4?Expires=1770744282&Signature=NQPcAhBZjN-765xtThDMdBt8n~Uh064NGmj29htAo7Oz9kc07uoxrt83d~Co59Tm6~XxXBKe1Rp72wBby5TIDZ6aIxT26EtmoUduyjvMvqYjxFvZ~4xXAEPpRDNPlr5vrPPg1Hggz2rQfovKCAr0LwBO7rO0WMND3oKjXBlUAeNFOqAUZ083AWtzAYjOT4tSo61FBOqywQZpCS4Qk~gzCDqI5re3x1Wi182g6-sONstgLNSYsz4FDJkIIbrO4rjBP8mBFYDQIlRYS9wVoz4QF1wDae88npguRQZZ9zbbbf5TbbB~2HPr1RBhymmQrT2qvhvCA~RckMRvJtO-PqCX9w__&Key-Pair-Id=KUT5TJCACFTXG","Medical school leaders briefed the Health Services Committee on accreditation standards and how each School of Medicine structures governance and quality improvement to meet the Liaison Committee on Medical Education (LCME) expectations.

“LCME accredits all MD-granting medical schools in the United States,” Dr. Michelle Daniel, vice dean for medical education at UC San Diego, said. She summarized LCME’s 12 standards and 93 elements and emphasized that “authority over curriculum content, pedagogy, and evaluation must rest within a school of medicine committee, not external bodies.”

Why it matters: LCME accreditation determines whether an MD program can grant degrees. The LCME requires that final authority over admissions, curriculum, grading and student advancement remain with the school of medicine and its faculty-led committees; campus or system bodies may advise but may not supersede medical‑school governance.

What the schools described
- Governance model: Deans and faculty executive committees (FEC) at UC medical schools hold ultimate responsibility for curriculum design and approval. Each school delegates to a medical education committee (MEC) and subcommittees (preclerkship, clerkship chairs, quality improvement) that run continuous review cycles and the “state of the curriculum” process.
- Data-driven review: Schools collect course evaluations, assessment data and outcomes for iterative improvement. Dean Steven Dubinette (David Geffen School of Medicine) said MECs conduct in-depth, data‑driven reviews across preclinical and clinical phases.
- Faculty and student engagement: Meetings of FEC and MEC are open to faculty and incorporate student feedback; UC Riverside highlighted a longitudinal “health equity / social justice” thread that all students experience.
- Challenges: Leaders cited change management for curriculum redesign, integrating interdisciplinary and longitudinal learning, and the need for timely, accurate data systems to support continuous quality improvement.

Regents’ questions and technology
Regents asked about cultural humility and curriculum threads addressing equity and communication. Leaders described required content on structural competence, societal problems and cultural competence, and provided examples of school‑wide threads and community‑based learning. Regents also asked about artificial intelligence; presenters said campuses are integrating computational medicine, radiology and predictive medicine initiatives and recommended a future dedicated briefing on AI in training.

Ending: Medical school leaders concluded that preserving faculty-driven governance aligned with LCME elements is essential to maintain accreditation and academic quality, and asked for ongoing regental support as schools adapt curricula to new science and societal needs.","Deans and faculty representatives told the Health Services Committee that LCME accreditation requires final curriculum authority to reside within each School of Medicine, and described internal governance, continuous quality improvement processes and data needs to maintain accreditation.","actionData","errors"]

Article not found

Regents briefed on federal Medicaid cuts in final reconciliation law and potential impacts on UC Health

UC Health leaders outline rising drug costs, urge exploring a UC-run PBM

Medical-school leaders brief Regents on LCME standards and faculty governance for curriculum oversight