How Obamacare Could Change Medi-Cal For the Better (and Worse)
The Affordable Care Act will help boost Medi-Cal enrollment, which could lead to positive trickle-down effects for California, but observers warn that the program is already dealing with funding and access concerns.
OIG Rule: States Can Use Federal Funds for Medicaid Data Mining
On Friday, HHS' Office of the Inspector General published a final rule allowing state Medicaid fraud units to use federal funding for data mining efforts to find fraudulent billing. OIG predicted that the final rule will save about $72 million from 2014 to 2023. Modern Healthcare, CQ HealthBeat.
Federal Ruling, State Law May Conflict
In 2011, the Legislature went along with the governor's plan to cut Medi-Cal provider rates by 10%. Provider groups immediately went to the courts to stop it, saying that patient access to care would be threatened by such a severe reduction. Now the final decision rests with a federal judge. A ruling is expected soon.
If a federal judge signs off on the law, Medi-Cal providers in California will have rates cut by 10% and also will need to pay back two years' worth of that 10% reduction. The effect would be a 15% rate cut for the next four years and a 10% cut thereafter.
The 10% cut represents about $600 million a year to the California budget.
Lawmakers, Hospital Leaders Push To Repeal Medi-Cal Cuts
At a news conference last week, two Assembly members -- Henry Perea and Jim Patterson -- and hospital administrators called on Gov. Brown and state lawmakers to stop a retroactive 10% cut to Medi-Cal reimbursements for hospital-based skilled nursing services. Patterson said two bills in the Legislature would allow lawmakers to reverse the "disastrous" cuts approved in 2011. Fresno Bee.
Doctors Still Waiting on ACA's Medicaid Payment Bump
Primary care physicians who participate in Medicaid still are awaiting a reimbursement increase five months after CMS issued a final rule on the Affordable Care Act provision. The increase was slated to take effect on Jan. 1, but only three states -- Massachusetts, Michigan and Nevada -- have implemented it so far, according to the American Academy of Family Physicians. Although all states have applied to start offering the higher rates, CMS only has approved applications for seven states. Kaiser Health News' "Capsules."
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