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Health Care Providers Sue State of California Over Cuts in Medi-Cal Payments
Date:5/5/2008

vailable to recipients at least to the extent that those services are available to the general public." 42 C.F.R. Section 447.204 "Medi-Cal already doesn't cover the cost of providing care," said Richard Frankenstein, M.D., president of the California Medical Association (CMA). "This chronic underfunding is forcing many doctors to leave the Medi-Cal program, which in turn deprives these vulnerable patients access to primary and preventative medical care. If these cuts take effect, Medi-Cal patients will be forced to seek care in already overcrowded hospital emergency rooms, which undermines access to care for all Californians."

According to the complaint, the reimbursement cuts authorized in February were implemented "solely due to state budgetary woes, without regard to the impact on the availability of Medi-Cal services." Such cuts are illegal, according to the complaint, and are "being imposed on a system already in crisis, wherein inadequate payment levels have resulted in a scarcity of willing providers, creating serious access hurdles for Medi-Cal beneficiaries." If the cuts are allowed to take effect, the lawsuit continues, additional health care providers will withdraw from the Medi-Cal program, which in turn will lead "to additional crowding of hospital emergency departments."

"California's emergency rooms are overburdened and chronically overcrowded," said Michael Salomon, M.D., president of the American College of Emergency Physicians, State Chapter of California (Cal/ACEP). "Ambulance diversions and patient wait times are on the rise -- with many patients having to wait hours, or even days, for a hospital bed. Slashing Medi-Cal payments will make things even worse."

California already ranks dead last in the nation when it comes to funding health care for Medicaid patients. According to the Kaiser Family Foundation, California spends $2,701 per Medicaid beneficiary -- the lowest rate in the nation. The national average is $4,662
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SOURCE California Hospital Association
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