Obama Administration Rejects California’s Request to Impose Mandatory Co-Pays February 6, 2012 Advocacy, CMA, News, Payment mandatory co-pay, Medi-Cal 0 The Centers for Medicare & Medicaid Services (CMS) rejected California’s request to impose mandatory co-payments for Medi-Cal patients. The co-pays, which would have included physician office and clinic visits ($5), ER visits ($50), and inpatient hospital stays ($100 per day up to a $200 maximum), was another attempt by the state to balance to budget by slashing Medi-Cal. Medi-Cal payment rates are grossly inequitable for emergency care as is, and the proposed co-payments exceeded the limits allowed by federal law for Medicaid cost sharing. The co-payments would have exceeded federal maximums, particularly for non-emergency use of the Emergency Department. Often, co-payments discourage low-income families from filling prescriptions for themselves or their children because they can’t afford it. When patients fail to take their prescription medications correctly, or stop taking their medications altogether, this seriously undermines their quality of life, quality of care, health care outcomes and the value of health care dollars spent. Providers, such as physicians and dentists, and advocates for low-income Californians warned that a co-pay plan would hurt low-income patients by cutting access to health care. Providers felt it was a back-door cut in reimbursement rates, because the state put the burden on them to collect the copays or make the decision to refuse patients for nonpayment. The rejection comes just days after Federal Judge Christina Snyder issued her final ruling in CMA et al v. Douglas. Her decision blocked the state from imposing a 10 percent reimbursement rate reduction to Medi-Cal physicians. Comments are closed.
