Possible Medi-Cal Payment Reductions
Part of the budget solution adopted by the Legislature and signed by the Governor in June called for a number of changes to reduce Medi-Cal costs. Those changes include co-pays on certain services, a cap on physician visits, and another 10% across the board reduction in Medi-Cal provider rates that was set to take effect on July 1, 2011.
Prior to these and any other program changes being made, the State must amend their Medicaid plan and obtain CMS approval. That approval has yet to occur and has been the subject of provider group visits with both CMS Region IX and a visit with Dr. Berwick, Director of CMS last week in Washington, DC. A similar 10% cut in 2008 was actually rejected by CMS in 2009 and prior to that was enjoined in federal court. Currently, a 1% reduction is still in effect and no attempt was made to enjoin that reduction. The federal court suit is now scheduled to be heard by the U.S. Supreme Court this Fall. Under federal law, there is an obligation for state Medicaid plans to assess the impact of any rate changes on beneficiary access to services.
It is likely that if CMS does approve the rate reductions, that a provider coalition may again seek injunctive relief. We will keep you informed of any decision.
SAVE THE DATE
Palmetto GBA J1's largest educational and networking event of the year! Join us October 18 through October 21, 2011, in San Diego and receive multiple Continuing Education Unit (CEU) credits for all the sessions you complete. Look out for more details on our J1 Part A or Part B Web sites in the next few weeks.
Click here for more information on the 2011 MACtoberfest.
November 29 - December 3
California Society of Pathologists
64th Annual Convention
"Seminars in Pathology"
Hyatt San Francisco in Embarcadero Center
5 Embarcadero Center
San Francisco, CA 94111