Sacramento- Today, the Centers for Medicare & Medicaid Services (CMS) rejected the state’s request to impose mandatory co-payments for Medi-Cal patients. The co-pays, which would have included physician office and clinic visits ($5), emergency room (ER) visits ($50), and inpatient hospital stays ($100 per day up to a $200 maximum), was another attempt by the state to balance the budget by slashing Medi-Cal.
“The Obama Administration has made the right decision. By federal law and our own ethics, physicians must treat patients that come to the ER, regardless of ability to pay. Imposing a mandatory co-payment would have done nothing to address costs or improve patient care. We are pleased that CMS understands that and has rejected the proposal,” James T. Hay, M.D., President, California Medical Association said.
Medi-Cal payment rates are grossly inequitable for emergency care as is, and the proposed copayments exceeded the limits allowed by federal law for Medicaid cost sharing. The copayments would have exceeded federal maximums, particularly for non-emergency use of the Emergency Department.
“These co-payments would for all intents and purposes be uncollectable and would have made it even harder for Medi-Cal patients to gain access to the care and medication they need,” Dr. Hay added.
Often, copayments discourage low-income families from filling prescriptions for themselves or their children because they can’t afford it. When patients fail to take their prescription medications correctly, or stop taking their medications altogether, this seriously undermines their quality of life, quality of care, health care outcomes and the value of health care dollars spent.
The rejection comes just days after Federal Judge Christina Snyder issued her final ruling in CMA et al v. Douglas. Her decision blocked the state from imposing a 10 percent reimbursement rate reduction to Medi-Cal physicians.