California Healthline: Will Twin Medi-Cal Cuts Affect Access?

by David Gorn

Reimbursement rates dropped Jan. 1 for Medi-Cal primary care providers in two 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 two years and expired on Jan. 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 two rate decreases that has Francisco Silva concerned. 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.

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  • LAAAC is managed by St. Barnabas Senior Services; Funded, in part, by Archstone Foundation.
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