Majority vote budget passed by California State Legislature, signed by Governor Brown July 1, 2011 CMA, News, Payment Medi-Cal, payments, reimbursement 0 Gov. Jerry Brown signed the 2011-2012 California State Budget yesterday. The new budget assumes $4 billion in additional revenue, based on an improving economy and higher-than-expected tax receipts for the past two months. If the state cannot produce the expected $4 billion, a series of tiered cuts of various types and amounts will be triggered. Included in the $200 million in "triggered" reductions is a $15 million Medi-Cal Managed Care cut. The budget also contains a $9 million "loan" of medical board funds to the state General Fund. The budget signed today continues to assume drastic cuts to health programs that the Legislature approved in March, including: A 10 percent across-the-board reimbursement cut for Medi-Cal providers; Mandatory copayments for Medi-Cal enrollees for doctor visits, prescriptions, emergency room visits and hospitalizations, ranging from $3 to $200; and, A seven-per-year "soft cap" on physician and clinic visits for Medi-Cal enrollees. SFMS and the California Medical Association (CMA) continues to fight these egregious reductions to the already broken Medi-Cal program and is in constant contact with the Centers for Medicare & Medicaid Services (CMS) on this issue. CMA has also organized a large provider coalition—the Alliance for Patient Care—to assist in these efforts. The Medi-Cal cuts will not, however, take effect unless CMS approves the state’s proposal. The state previously announced plans to submit an official proposal to implement the cuts to the federal government for approval by June 30, the final day of the state’s fiscal year. (If the cuts are approved, the state plans to make them retroactive to June 1.) While we will be required to wait and see which of the above cuts take effect, SFMS/CMA was able to ensure that a number of items were kept safe in this year’s budget, including: Protecting the Healthy Families program. We were successful in removing language that would have moved children from Healthy Families into Medi-Cal, which would have been a devastating cut to the safety net and threatened access to care for California’s neediest children; Preserving $7.3 million to provide vaccines for low-income, uninsured Californians; Allocating $4.4 million in additional funds resulting from interest earnings to the Every Woman Counts breast and cervical cancer screening program; Preventing any diversion of Maddy Fund monies into the state’s coffers; Protecting funding for the Emergency Medical Services Commission, which oversees planning for emergency services statewide; and, Creating the Keeping Adults Free from Institutions program to provide adult day health services to eligible individuals. It is worth noting that another substantial policy change contained in the budget is to authorize the Department of Health Care Services to develop a new methodology for reimbursing pharmacy products utilizing Average Acquisition Price. We will post updates in the SFMS blog as these issues move toward final resolution, and will continue to be actively involved in the process in order to ensure that all Californians have access to quality care when they need it. Comments are closed.
