Legislation introduced to restore Medi-Cal funding February 20, 2014 Medi-Cal ACA, Insurance/Reimbursement, Medi-Cal, Medi-Cal Cuts, State Legislative Advocacy, Affordable Care Act, We Care for California 0 Today Assembly Budget Chair Nancy Skinner and Assembly Health Chair Richard Pan, M.D., introduced two bills, one that would restore the 10 percent Medi-Cal physician payment cut that went into effect this year and another that would extend the temporary Medi-Cal primary care rate increases called for under the Affordable Care Act (ACA). “I have sought to make the Medi-Cal program more cost-effective, transparent and accountable,” said Dr. Pan. “The legislation that we are introducing today continues this effort.” Medicaid rates in California are the lowest in the nation, while the state has arguably the highest practice costs anywhere in the country. With physicians paid just $18 a visit for primary care services, many patients are already having a tough time finding access to quality medical care. “Without adequate payment, Medi-Cal becomes an empty promise of coverage without actual access to care,” added Dr. Pan. “Getting a pizza delivered costs about the same as what California now reimburses doctors for Medi-Cal patient visits, it should be clear to everyone which service is worth more,” said Assemblymember Skinner. “California needs to fix reimbursement rates so we don't undermine the very program designed to cover millions of individuals and families in need of health care.” AB 1805 will improve health care access by bolstering provider participation in Medi-Cal, a program California expanded last year as the state moves forward in aggressively implementing the ACA. Specifically, AB 1805 will restore the 10 percent cut to Medi-Cal provider reimbursement rates that were enacted as part of the 2011 State Budget Act. AB 1759 extends through 2015 (and indefinitely beyond) the reimbursement increase for certain Medi-Cal primary care providers called for under the ACA and set to expire on December 31, 2014. “Patients in our communities are already having a difficult time finding access to care,” said Richard Thorp, M.D., California Medical Association (CMA) president. “The legislation being introduced today will help to ensure that patients have real access to care as millions of new patients are enrolled in Medi-Cal.” More than 8.5 million Californians receive their health care from the Medi-Cal program – one in every five patients in the state – and this number will rise drastically this year when over 2 million new patients enter the system under the ACA. The bill continues the work that CMA has already been engaged in since 2011 when 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 in 2013. 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 it to review the appeals court ruling. The Court decided not to take this petition in January 2014. CMA is part of an unprecedented coalition of physicians, dentists, health care workers and hospitals that is 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. Comments are closed.
