Gov. Brown's proposed budget eliminates retroactive Medi-Cal cuts January 14, 2014 Medi-Cal Medi-Cal, Insurance/Reimbursement 0 Governor Jerry Brown this morning announced that the State of California would not be moving forward with retroactive collection of a 10 percent cut to the Medi-Cal program, a win for physicians and patients in California. The announcement came as part of the governor's 2014-2015 fiscal year budget proposal. "The Governor’s budget demonstrates a clear understanding of the importance that California’s Medicaid (Medi-Cal) program has for the state’s poorest and most vulnerable patients," says Richard Thorp, M.D., president of the California Medical Association (CMA). “After voicing a commitment to expand Medi-Cal eligibility and ensure that the rollout of the Affordable Care Act in California be a success, restoration of the retroactive cut is a huge step in the right direction." Unfortunately, the budget does not stop the 10 percent cuts moving forward. Although elimination of the retroactive cut is a huge step in the right direction, an additional 10 percent cut will only cement California in the position of having the lowest Medicaid rates in the nation. While this budget will provide some relief to physicians who may have otherwise been forced to stop taking new Medi-Cal patients altogether, it does not go far enough. CMA is part of an unprecedented coalition of physicians, dentists, health care workers and hospitals that will continue working to stop the cuts. The coalition, called “We Care for California," includes the largest statewide organizations representing physicians, dentists, hospitals and health care workers, as well as health plans, first responders, caregivers and other health providers. CMA and the We Care for California coalition will continue to push for full restoration of the cuts moving forward. “As the rest of the nation looks to California for an example of health reform success, we simply cannot move forward with a 10 percent prospective cut to the Medi-Cal program while simultaneously adding new patients to the program," says Dr. Thorp. Under the Affordable Care Act, more than 3 million patients are expected to enter Medi-Cal over the course of the next two years. “CMA and our stakeholder partners will look toward reforms that will result in real access to care so that health reform is more than an empty promise of an insurance card," says Dr. Thorp. In March of 2011, the California Legislature passed and Governor Jerry Brown signed AB 97, which included a 10 percent reimbursement rate cut for physicians, dentists, pharmacists and other Medi-Cal providers. The cuts were enjoined for two years while the matter was being argued in a CMA-filed lawsuit. Despite earlier favorable rulings, a three judge panel of the 9th Circuit Court of Appeals cleared the way for implementation of these rate reductions. CMA requested a rehearing from the full Ninth Circuit Court of Appeals, which was denied. In September 2013, CMA filed a petition with the United States Supreme Court, asking them to review the appeals court ruling. The Court has not yet ruled on this petition. Even before the cuts, California's Medi-Cal provider payment rates were the lowest in the nation. Low reimbursement rates have forced many of California’s providers to stop seeing Medi-Cal patients. As a result, 56 percent of Medi-Cal patients report difficulty finding a doctor. If these cuts are not stopped, Medi-Cal will become nothing more than a broken promise of access to care. Comments are closed.
