No Public Input in Latest Medi-Cal Cuts


Posted on 14 March 2012

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By Andrés E. Jiménez
Greenlining Institute

When making a decision that affects the quality of health care for millions of Californians and the livelihoods of the state’s physicians and pharmacists, one would think the state and federal government departments responsible would take into account input from the public and well-informed stakeholders.

But when it comes to the recently approved 10 percent cut to Medi-Cal reimbursement rates, which was not the case. There was not a single public hearing. So it’s hard to say what is more troubling: yet another cut to Medi-Cal patients, or the absolute lack of public input of any kind in making that decision.

Late last month, the federal government approved California’s request to cut -- by another 10 percent -- the reimbursement rates to medical professionals who serve the 7.7 million patients who rely on Medi-Cal. The cuts will be retroactive to June 1. These new cuts will lead to fewer physicians and pharmacists able to provide health care services to Medi-Cal enrollees, diminished health services of numerous Californians, and more economic strain upon our health care providers.

Through Medi-Cal, the state ostensibly reimburses physicians, pharmacists, and hospitals for the costs of providing essential health care services to Medi-Cal clients. But over recent years, those reimbursements have suffered a steady string of reductions. Take those cuts, add them to the fact that costs in the health care system continue to rise, and the equation stops penciling out for many medical professionals.

Already, many medical and health professionals know that Medi-Cal patients face numerous challenges. Another reduction in reimbursement rates will mean doctors and hospitals will address administrative and cost issues other than providing the best care for their patients. Medical and health care professionals need fair reimbursement in order to provide proper care for those who need their services and we need their services. Without this reimbursement both the Medi-Cal and general population suffer due to the decline in reasonable health care coverage for Californians.

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Andrés E. Jiménez is Senior Public Policy Analyst at the Greenlining Institute and directed the University of California system wide California Policy Research Center for 17 years that included two major health policy programs. He writes on federal and state public policy from Berkeley, California. This article originally appeared in the Berkeley Daily Planet.

Medicaid/Medical are too expensive. It helps some really needy people, but much is wasted. People who get on the rolls are not vetted properly. Social workers want to expand their pool of clients, so they readily approve anybody. They even show them how to "spend down" their money to qualify.