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I Wouldn't Be In A Rush To Defend The Medi-Cal Cuts Either

by: Brian Leubitz

Tue Dec 22, 2009 at 10:30:00 AM PST


In something the state's attorneys are calling a misunderstanding, federal judges have accused the state of lying to the court. That's something of no-no under State Bar ethics rules.

The court said health officials, through their lawyers, had lied about why the state waited more than a year to make its current arguments in the case. Brown's office said the court's comments were "based on a misunderstanding" that the state's lawyers will try to clear up in the next few days.

In July, the court ruled that the state had violated federal law with 2008 legislation that cut by 10 percent the rates it paid to doctors, dentists, pharmacists, clinics and adult day health care centers serving 7.1 million poor people in the Medi-Cal program. The ruling required the state to reimburse health care providers hundreds of millions of dollars that the state cut from their fees from July 2008 to March 2009, when a new law took effect setting rates at 1 to 5 percent below July 2008 levels. The court said state health officials and legislators were simply trying to save money and did not study how the cuts would affect Medi-Cal patients, as federal law requires. (Sf Chronicle)

This may seem like ancient news in internet time, especially considering the law lowering Medi-Cal payments is no longer in effect. However, the federal courts can still require reimbursement to the doctors that got the lower rate. Of course, the problem with these cuts wasn't just the pay rates, it was the fact that many doctors got scared off of ever providing Medi-Cal services.  The cost of filling out the forms isn't much less than the reimbursement rates for some services, so why bother at all? And even with the slightly higher rates restored, the incident makes it abundantly clear how it's going to be every year. Why deal with that risk, when you can always go work for a pittance for Blue Shield's coverage.

Medi-Cal is straining at the seams, and the more we deny it, the more waste we will see. Not only waste of money, but of human resources and human lives.

Brian Leubitz :: I Wouldn't Be In A Rush To Defend The Medi-Cal Cuts Either
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