Governor Suggests Radiology Cuts in Medi-Cal in Budget Revise
On May 14th, the Governor released what is known as the May Revise. It included cuts for radiology payment under Medi-Cal. The Revise is intended to update his budget proposal for the fiscal year beginning on July 1, 2010. His January budget proposal called for the elimination of Healthy Families, the In Home Supportive Services Program and some optional services unless the federal government provided an additional $7 billion in new funds for heath programs.
The May Revise calls for annual limits on the number of physician visits, over the counter medications and a reduction in payments for radiology services in Medi-Cal to rates that do not exceed 80% of the Medicare payment rate for the same services. This is a new proposal and we are still assessing the impact. We are aware that for some services, like specific MRI procedures, the Medi-Cal rate is actually significantly higher than the Medicare rate due to the impact of the DRA cuts. We also know that in some cases the Medi-Cal rate is significantly below the Medicare rate. This would also lower current breast screening payments under Medi-Cal.
The CRS will strongly oppose this reduction and the impact it will cause on access to imaging services by Medi-Cal patients. These reductions would likely be subsequently adopted in Medi-Cal managed care plans and county operated systems. The budget crisis is very real and very deep with an unknown time frame for resolution. We will provide you with additional information to reach out to budget conferees once that process begins next month.
New Regulation from Medical Board Requires Physicians to Post Notice
We have been contacted by some members who have learned of the new regulation effective June 27, 2010 which requires that all physicians notify patients that they are licensed by the Medical Board of California. All physicians, including radiologists, must either provide the notice by either, posting a notice via specific type of sign, include the notice in a statement signed by the patients or their representative and retain it in the patient file, or include the notice in a statement on letterhead, discharge instructions or other document given to a patient or their representative, where the notice is in 14 point type immediately above the patient signature line.
You can see the specifics by going to www.mbc.ca.gov and looking at the Notice to Consumers Regulation. The CRS is in contact with the Medical Board to determine if radiologists can be exempted or the requirement modified to take into account that patients may not see the radiologist. There is a short window before the requirement begins and we will advocate for changes.
Legal Challenge Filed to FTC Red Flag Rule
A suit was filed in federal court on May 21st to challenge the FTC Red Flag Rule that is set to take effect on June 1, 2010. The Rule would impact physician practices that extend credit for payment and require that they adopt a plan to safeguard patient/consumer financial information. Though intended for financial institutions the effort by organized medicine to exempt physician practice has to date only resulted in delays but not exemption. The lawsuit was filed in federal court in Washington DC led by the AMA. It is not likely that the suit would delay the official implementation date of June 1.
