Doctors, Pharmacists Sue State, Seek Data on Effects of Medi-Cal Cuts

CAL/AAEM News Service - BP at
Thu Oct 13 11:55:52 PDT 2011

Description: Description: Description: Description: CAL/AAEM: California
Chapter of the American Academy of Emergency Medicine

October 4, 2011

Doctors, Pharmacists Sue State, Seek Data on Effects of Medi-Cal Cuts




The California Medical Association and the California Pharmacists
Association have filed a lawsuit against the state Department of Health Care
Services for not disclosing the effects that proposed Medi-Cal cuts would
have on beneficiaries, the Sacramento Bee reports. Medi-Cal is California's
Medicaid program (Yamamura, Sacramento Bee, 10/4).




In late June, Gov. Jerry Brown (D) signed a state budget package that
includes changes to health and human services programs. For example, the
budget aims to reduce state spending by:


.     $623 million by cutting health care providers' reimbursements for
Medi-Cal by 10%; 

.     $511 million by requiring Medi-Cal beneficiaries to pay $5 copayments
for physician visits and $50 copays for emergency department visits; and 

.     $41 million by imposing a soft cap of seven physician visits annually
and placing a dollar limit on hearing aids for Medi-Cal beneficiaries.


Federal officials must approve the Medi-Cal adjustments.


A 90-day federal review period went into effect after Brown signed the
budget. A final decision could be delayed because federal officials have
said they will need California to provide more data on the cuts' possible
effects on access to care (California Healthline, 8/26).


Seeking Information


The lawsuit seeks to obtain information that the state submitted to CMS
about how the Medi-Cal changes would affect access to care.


Jon Roth, CEO of the pharmacist association, said state officials "owe it"
to Medi-Cal beneficiaries to be open with requests for such information
(CPhA release, 9/30).


DHCS has rejected a Public Records Act request that the associations filed,
as well as a similar request made by the Bee.


DHCS said it rejected the Bee's request because disclosing the information
would impede the state's opportunity to have "candid policy discussions"
with federal officials (Sacramento Bee, 10/4).Emergency departments are
increasingly serving as the safety net for medically underserved patients,
especially adults with Medicaid, a study published in the Journal of the
American Medical Association concluded. As evidence of this trend, the
co-authors point to the rise in rates of visits to EDs in the U.S. among
adults on Medicaid.





Marcus Williams &
Brian Potts MD, MBA
Managing Editors, CAL/AAEM News Service



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