Governor Signs Budget Cuts Bill 

This afternoon the Governor signed a package of bills that cut state spending by an estimated $14 billion. That package includes a bill that makes cuts to Medi-Cal spending by about $1.7B which contains cuts in the following areas;

•  A 10% provider rate cuts for all providers set to take effect in June 1, 2011.   That includes both physicians and clinical laboratories;
• Co-pays of $5 on physician office and clinic visits, co-pays in the ER and in-patient stays, drugs. There is no co-pay for clinical labs; and  
• Cap on physician visits of 7 per year ( It is a "soft" cap which can be exceeded by TAR). 

All these changes will not be implemented until the State Plan Amendment (SPA) is approved by CMS. That SPA was to be submitted by DHCS after the bill was signed. It is not clear whether CMS will approve any or all of these Medi-Cal changes. CMS did in fact reject in 2010 the SPA submitted on the prior 10% cut in 2008-09. There is an appeal and decision pending in the US Supreme Court on whether that prior 10% reduction was lawfully enjoined. In 2008 there was an injunction issued in federal court against that 10% cut for physicians, dentists and pharmacies among others. It did not enjoin the cut for claims paid to clinical lab providers under Medi-Cal. That 10% reduction lasted until March 1, 2009 when it was reduced to a 1% reduction.

Bill to Allow Optometrists to Perform Waived Tests and be Lab Director 

AB 761 (Hernandez) is sponsored by the Ca. Optometric Association and would allow optometrists to act as Lab Directors and allow them to supervise the performance of waived tests for conditions that are within their scope of practice. In initial conversations with the sponsors they indicate the desire to perform waived tests beyond conditions involving the eye. They have indicated a desire to perform glucose testing for the detection of diabetes, urinalysis, and sedimentation rate.

The CSP has indicated their concerns with both the education/training and need for optometrists to perform the broad range of waived testing. We will be in discussions with the author and sponsor in the coming weeks. It has been double referred to both the Assembly Business and Professions and Health Committees.

SAVE -THE-DATE 

The CSP 64th Annual Convention "Seminars in Pathology" will be held  

November 29 - December 3, 2011