As posted on the SFMS blog last week, CMS approved
California’s state plan amendment to reduce Medi-Cal reimbursements to clinics, doctors, laboratories, optometrists, pharmacists, and some nursing facilities by 10 percent.
CMA has filed a petition
with CMS asking that corrective action be taken to address current reimbursement rates and access standards.
Officials with California’s Department of Health Care Services said the cuts are retroactive to June 1, meaning health care providers will have to return money to the state or have the funds subtracted from upcoming payments.
Califoria’s Medi-Cal reimbursement rates are already the lowest in the nation, and reducing payments will further compromise the safety net for low-income residents. With the new cuts, physicians will be reimbursed $11 per Medi-Cal patient visit, when it costs the physician several times that to provide.
Physicians will be forced to reduce the number of Medi-Cal patients they accept, if they can continue to see any at all.
Recent data from the California Office of Statewide Health Planning and Development, compiled by the American College of Emergency Physicians, shows a significant increase in emergency room visits since 2005 by Medi-Cal beneficiaries. On average, ER use by Medi-Cal patients increased 30 percent between 2007 and 2009 (most recent reporting period). This demonstrates that Medi-Cal beneficiaries are already being forced to seek necessary care in the ER when they can’t find a physician. The new round of provider payment reductions will ensure overcrowding in emergency rooms and will absolutely mean less access to care for all Californians.