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Will Twin Medi-Cal Cuts Affect Access?
The combination of 2 Medi-Cal primary care rate decreases could mean primary care providers who see a lot of Medi-Cal patients will have to scale back or stop seeing those beneficiaries.
Reimbursement rates dropped January 1 for Medi-Cal primary care providers in 2 ways:
- A provision of the Affordable Care Act temporarily set primary care reimbursement rates at Medicare levels, significantly higher than Medicaid payments. The increase lasted 2 years and expired on January 1.
- A state reduction in Medi-Cal reimbursement for primary care providers hit on the same day. The 10% rate cut, approved by the California Legislature in 2011, was held up while the matter was thrashed out in court. Last year, the courts upheld the state's right to reduce provider reimbursement and health care officials decided to implement the cutbacks in phases. The last phase, which includes primary care providers, went into effect Jan. 1.
The federal drop is much more precipitous, but it's the combination of the 2 rate decreases that has Francisco Silva concerned. Mr Silva, vice president of legal affairs at the California Medical Association, said primary care providers who see a lot of Medi-Cal patients will have to scale back or stop seeing those beneficiaries.
Read more: http://bit.ly/1wxH09Z
Trump Administration’s Message to Supreme Court Puts New Wrinkle in Braidwood Case
February 21st 2025The Trump administration argues that HHS Secretary Robert F. Kennedy Jr can overrule the US Preventive Services Task Force to determine the preventive services covered under the Affordable Care Act.
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Varied Access: The Pharmacogenetic Testing Coverage Divide
February 18th 2025On this episode of Managed Care Cast, we speak with the author of a study published in the February 2025 issue of The American Journal of Managed Care® to uncover significant differences in coverage decisions for pharmacogenetic tests across major US health insurers.
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NSCLC Advancements Offer Hope, but Disparities Persist
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