CA to expand Medicaid rolls while cutting payments

Having restored its fiscal health while planning to dramatically expand its Medicaid program, California is in the curious position of cutting provider payments while continuing to add enrollees, Bloomberg News reported.

California is adding one million new enrollees to Medi-Cal, the state's Medicaid program, at the same time it has taken enormous budget deficits and turned them into a surplus, according to Bloomberg,

"While the budget has indeed been brought into balance, that balance is by a narrow margin," H.D. Palmer, a spokesman for the California Department of Finance, told Bloomberg. "That's why the budget assumes that the difficult but necessary reductions that helped bring the budget into balance are ongoing."

California already has some of the lowest provider rates in the nation, paying on average 53 percent of Medicare rates. For example, a gynecological exam currently pays $25, a fee that is set to go down 10 percent next year--along with additional withholdings to cover prior overpayments. Private insurers pay between $95 and $200 for the procedure, according to Bloomberg.

Meanwhile, the Medi-Cal program plans to slightly raise rates to primary care physicians in order to guarantee the million residents expected to enroll next year under the ACA. And planned payment cuts to skilled nursing facilities attached to hospitals have been averted, according to Bloomberg.

To learn more:
- read the Bloomberg News article

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