Today there were actions taken in both the Assembly and Senate that defined what actions each House is proposing in their version of the budget regarding the Medi-Cal 10% cut that has been implemented and the claw back of the 10% to June 1, 2011. Some providers have already been exempted from the claw back but DME, medical supplies and enteral formula were not included in the Governor's budget proposal.
In the Assembly, their budget sub-committee with Medi-Cal jurisdiction voted to eliminate the retroactivity for all providers and to eliminate the 10% reduction that has been implemented for all providers. For DME it began in October 2013 and medical supplies in February 2014. When the 10% cut would be eliminated is unclear and will be the subject of further negotiation, but it will be prospectively done, i.e. January 2015. This subcommittee action will need to be confirmed by the full Assembly Budget Committee next week - but that will occur.
Meanwhile the full Senate Budget Committee adopted a series of proposals regarding Medi-Cal. Those include: (1) eliminate the 10% cut for all providers on a prospective basis, again a date to be determined, (2) no expansion of providers exempt for the claw back and retroactivity, and (3) restoration of some optional benefits eliminated several years ago, including incontinence creams and washes.
Once each House has passed their version of the budget they will convene a Conference Committee comprised of three members from each House. They will then meet over the coming weeks to resolve differences between the two versions of the budget and send a final version to the Governor prior to June 15th. Once the Conference Committee members are chosen we will notify and ask that you contact them all to advocate for the Assembly version of the Medi-Cal provider rate provisions to eliminate the claw back and the 10% reduction.
Medi-Cal 008 Denials for Incontinence Supplies
CAMPS continues to push for a fix to this problem. DHCS has indicated that this is a priority for resolution. We know that providers have been impacted for weeks and cash flow is an issue. We hope to have news for you by next week.
