Second bill to increase Medi-Cal rates advances through first committee -AND- ED physicians say visits continue to rise

Tue May 19 23:34:33 PDT 2015

May 4, 2015

Second bill to increase Medi-Cal rates advances through first committee

CMA Alert

California’s policymakers are continuing to show support for legislation that would fully fund the state’s Medicaid (Medi-Cal) program. Two bills would restore a 10 percent reimbursement rate cut and raise those rates to Medicare levels, allowing better access to health care for patients

Assembly Bill 366 (Bonta, D-Oakland) and Senate Bill 243 (Hernandez, D-West Covina) are currently moving through the legislature. AB 366 took its first step through the legislative process when it advanced to the Assembly Appropriations Committee with unanimous approval on April 14. Last week, it was SB 243’s turn.

SB 243 came before the Senate Health Committee on April 23, where Senator Ed Hernandez described the necessity for passing the bill.

“Expanding access to health coverage as we’ve done under the ACA [Affordable Care Act] is a significant accomplishment,” he said. “But in order to truly be revolutionary, coverage must be accompanied by meaningful access to a provider. Unfortunately, millions of Californians in the Medi-Cal program lack the access because we pay the providers an embarrassingly low rate.”

The amount of money California pays providers for a regular primary care visit under Medi-Cal is just $16, putting the state nearly last in the country for Medicaid reimbursement rates. California also had the second lowest physician participation rate in Medicaid programs. Studies show a direct correlation between the two.

By next year, it is expected that over 12 million Californians — or nearly one-third of the state’s residents — will be enrolled in Medi-Cal, making the current model for reimbursement unsustainable, according to Hernandez.

Senate members in the health committee seemed to agree, voting 8-0 to move the bill to the Senate Appropriations Committee. 

May 5, 2015

ED physicians say visits continue to rise

AHA News Now

Three-quarters of emergency physicians say the volume of emergency department visits has increased since January 2014, when the Affordable Care Act required all Americans to have health insurance or pay a tax penalty, according to a new survey by the American College of Emergency Physicians. About 90% of respondents say the severity of illness or injury among emergency patients has either increased or remained the same. “The reliance on emergency care remains stronger than ever,” said ACEP President Michael Gerardi, M.D. “It’s the only place that’s open 24/7, and we never turn anyone away.” Asked what would happen if federal subsidies for health insurance coverage were eliminated in their state, 42% of respondents said they would expect emergency visits to increase and 65% said they would expect reimbursement for emergency care to decrease. The U.S. Supreme Court is expected to rule next month in King v. Burwell, which asks whether subsidies are available for patients in the 34 states whose health insurance exchanges are federally facilitated.

Bryan Sloane
Deputy Editor, CAL/AAEM News Service

Brian Potts MD, MBA
Managing Editor, CAL/AAEM News Service

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