For those radiologists providing screening mammography or other services to women enrolled in the Every Woman Counts program, you should be aware that claims are not being paid for dates of service on or after July 1, 2010. That is the start of the new state fiscal year and with no budget deal state only funded programs like EWC can't be reimbursed. You are advised to continue submitting claims, and hopefully once a budget is in place those claims will be paid.

The EWC program has a current budget shortfall of $25 million. The structure of funding for this program is part of the budget deliberation process. How the program is structured, e.g. are women under 50 eligible for screening, is obviously part of the discussion and we don't know what the final program will look like. The CRS joins the Komen Foundation and others in arguing to restore eligibility for fifty and under and resume enrollment of other eligibles. The CRS met with the EWC program last week for a status update.

Possible Medi-Cal Reductions for Radiology

We previously informed you that in his May Revise to the state budget, the Governor proposed that Medi-Cal reduce any payments for radiology services to no more than 80% of the Medicare allowable. That would result in reductions in current allowable for many MRI and CT procedures.

The CRS has testified in opposition to this change during the budget committee process. The change was adopted in the Senate and rejected by the Assembly and has been in the Conference Committee process for over a month. The good news is that it has not been adopted but we are still at risk in a very bad budget situation. If this was adopted it would likely take effect on October 1, 2010. We will continue to oppose any reduction.

We look forward to seeing you in San Francisco!