The California Medical Association (CMA) joined with the California Dental Association, the California Pharmacists Association and the National Association of Chain Drug Stores to file a lawsuit against the California Department of Health Care Services (DHCS) and the U.S. Department of Health and Human Services (HHS) today. The suit is in response to the recent approval of a 10 percent reimbursement rate cut for Medi-Cal providers.
“In late September, CMS asked DHCS for more information that would substantiate their state plan amendments (SPAs) for cuts in the Medi-Cal program. Without receiving that information, CMS went ahead and approved the cuts,” said Francisco J. Silva, CMA General Counsel and Vice President. “It is clear that CMS did not follow protocol and applied the wrong legal standard. The approval of the SPAs will have dramatic effects on access to health care for the poorest, most vulnerable Californians.”
According to Silva, federal law requires that Medi-Cal patients have the same access to physicians and other health care providers as the general insured public. “CMA strongly believes that even before these cuts, California is in violation of federal access law,” he notes.
“Medi-Cal patients are already having a tough time getting access to care," says CMA President James T. Hay, M.D. "The approved cuts are irresponsible and will only put the health of California’s most vulnerable population further at risk. The federal government has made a terrible mistake in approving the cuts, especially in the face of health care reform. We simply cannot treat more patients with fewer resources.”
California's Medi-Cal rates are already almost the lowest in the nation. Currently, half the doctors in the state cannot afford to participate in the program. The gaping hole in California’s safety net will be further exacerbated by the 3 million uninsured newly eligible for Medi-Cal in 2014 under federal health reform legislation.
An independent study recently commissioned by CMA found that 49 percent of Medi-Cal patients are unable to get health care when they need it, compared to just 26 percent of privately insured patients.
What you can do
CMA and its member physicians want to make sure that Medi-Cal patients have access to health care. But we need your help. Contact CMA if you, your clinic or medical group can no longer afford to treat Medi-Cal patients, cannot find specialists who take Medi-Cal patients, or would otherwise be negatively impacted by the recent cuts that California made to the Medi-Cal program. You can also download a form to give to your patients to determine how they're being affected. You can help us in our efforts to reverse these cuts.
Contact: Michelle Rubalcava, (916) 551-2543 or mrubalcava@cmanet.org.