California Has Not Issued Report On Physician Medicaid Payments

Armen Hareyan's picture

California has not been complying with a statelaw that requires the Medi-Cal director to review physician reimbursementrates annually and ensure that Medi-Cal beneficiaries have access to physicianand dental services, the Sacramento Bee reports. Medi-Cal is California'sMedicaid program.

Sandra Shewry -- director of the state Department ofHealth Care Services,which administers Medi-Cal -- said the report has not been completed in thepast 15 years. Shewry said the law is an "obsolete statute" that is aholdover from when health care expenditures made up a smaller portion of thestate budget and the health department made annual recommendations foradjustments in the rates. The law, passed in 1976, is intended to keepphysician reimbursement rates competitive with other insurance programs, aswell as to ensure "reasonable access" to health services.


Last month, the Legislature approved a 10% cut to Medi-Cal physicianreimbursements to help address an $8 billion budget deficit that the statefaces through June 2009. Critics contend that the cuts are being made withoutfull understanding of their statewide effects. Ned Wigglesworth, a spokespersonfor the California Medical Association, said, "Here you have thisstatute that's being ignored, and the medical program that's supposed to be asafety net has frayed and eroded," adding, "The funding decisionshave been made unnecessarily in the dark." According to the CMA, physicianreimbursements for Medi-Cal are the lowest of any state Medicaid program.

Assembly member Patty Berg (D), a critic of the Medi-Cal cuts, said theadditional information from the report would have been helpful in consideringthe rate cuts, but she said, "I probably don't have to wait for a reportto know the rates are too low." Berg estimated that the statewide deficitcould increase to $10 billion.

San Francisco Mayor Gavin Newsom has threatened a lawsuit to block the cutsfrom taking effect (Lin, Sacramento Bee, 3/28).

Reprintedwith permission from You can view the entire Kaiser Daily Health Policy Report, search the archives, and sign upfor email delivery at . The Kaiser Daily Health PolicyReport is published for, a free service of The Henry J.Kaiser Family Foundation.


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