CMS, the federal Centers for Medicare and Medicaid Services has approved California state budget proposals to reduce Medi-Cal provider reimbursement rates by 10 % , which will have consequences for Medi-Cal patients to find quality health care providers in California.
The Budget cut assumes a savings of$ 623 million General Fund from the reimbursement proposals.
Specifically, these proposals received approval:
* A 10 % provider payment reduction on a number of outpatient services , including physicians, clinics, optometrists, therapists, laboratories, dental , durable medical equipment and pharmacy.
* A 10 % provider payment reduction for freestanding nursing, adult subacute facilities, and for distinct part/nursing facility-B services.
As a consequence to the 10 % reimbursement rate reduction fewer doctors will be willing to see Medi-cal patients, which are in California approx. 7.6 million poor and disabled Californians.
A 10 % reduction for physician/ clinic services for children was not approved.
Until further discussion with CMS is the proposed “soft cap” of seven visits for physicians and clinics and requiring a beneficiary co-payments on most Medi-Cal covered services. The total Medi-Cal budget restrictions total is planned to be $ 1.7 billion for the fiscal year of 2011-12.
With California being almost bankrupt, cuts in Medi-Cal are unavoidable, but it will be harder for the Medi-Cal patients to find quality health care providers willing to treat the poor and disabled.