California Assembly Bills Introduced To Reverse, Study Effects of 10% Cut to Medi-Cal Providers February 20, 2014 Advocacy, Medi Cal, News 10% Medi-Cal cut, AB 1759, AB 1805, Medi-Cal, Medi-Cal provider rate cut 0 Assembly Budget Chair Nancy Skinner and Assembly Health Chair Richard Pan, MD, introduced two bills to reverse the 10% cut in Medi-Cal provider rates and extend the temporary Medi-Cal primary care rate increases called for under the Affordable Care Act. AB 1805 will improve health care access by bolstering provider participation in Medi-Cal, a program California expanded last year as the state moves forward in aggressively implementing the ACA. Specifically, AB 1805 will restore the 10% cut to Medi-Cal provider reimbursement rates that were enacted as part of the 2011 State Budget Act. AB 1759 extends through 2015 (and indefinitely beyond) the reimbursement increase for certain Medi-Cal primary care providers called for under the ACA and set to expire on December 31, 2014. The provider rate reduction started going into effect in September last year after the law was held up in court for more than two years. California providers, who already faced some of the lowest Medicaid reimbursement rates in the country before the cuts were approved, will fall even further behind their counterparts in other parts of the country as the cuts are implemented. More than 8.5 million Californians receive their health care from the Medi-Cal program—one in every five patients in the state—and this number will rise drastically this year when over 2 million new patients enter the system under the ACA. “Getting a pizza delivered costs about the same as what California now reimburses doctors for Medi-Cal patient visits, it should be clear to everyone which service is worth more,” said Assemblymember Skinner. “California needs to fix reimbursement rates so we don't undermine the very program designed to cover millions of individuals and families in need of health care.” The bills continue the work that SFMS/CMA has already been engaged in since 2011 when the California Legislature passed and Governor Jerry Brown signed AB 97, which included a 10% reimbursement rate cut for physicians, dentists, pharmacists and other Medi-Cal providers. The cuts were enjoined for two years while the matter was being argued in a CMA-filed lawsuit. Despite earlier favorable rulings, a three judge panel of the 9th Circuit Court of Appeals cleared the way for implementation of these rate reductions in 2013. SFMS/CMA requested a rehearing from the full Ninth Circuit Court of Appeals, which was denied. In September 2013, SFMS/CMA filed a petition with the United States Supreme Court, asking it to review the appeals court ruling. The Court decided not to take this petition in January 2014. SFMS/CMA is part of an unprecedented coalition of physicians, dentists, health care workers and hospitals that is working to stop the cuts. The coalition, called “We Care for California," includes the largest statewide organizations representing physicians, dentists, hospitals and health care workers, as well as health plans, first responders, caregivers and other health providers. Comments are closed.
