They Giveth and They Taketh
There is more bad news from the State Medicaid program as the difficult economic times impact this program.
In an effort to reach a balanced budget, Gov. Daniels asked each state agency to rein in spending for the next fiscal year. Doing its part, the Family and Social Services Administration (FSSA) presented a budget that proposed paying health care providers 95 percent of the fee schedule per claim, beginning July 1, 2009.
It was in the Fall of 2007 that physicians were told the Medicaid reimbursement rates would increase by about 1.5 percent. This was the first increase physicians had since the early 1980’s.
This proposed 5 percent holdback will result in a net decrease of 3.5 percent in July. This will not be acceptable to physicians and many of us will just stop seeing Medicaid patients completely.
“It is unfortunate that the current state of the economy is forcing Medicaid to take the extreme action of a 5 percent holdback,” said Michael Rinebold, ISMA director of Government Relations.
“The process to implement the changes does not require legislation, but it will require administrative rulemaking, which is expected to be completed within six months.”
Jeffrey M. Wells, M.D., director of Office of Medicaid Policy and Planning, hoped the provider rate withhold could be avoided but, said it is critical that the agency plan for the worst. “With the recent revenue forecast showing challenging economic times ahead and with the governor’s commitment to a balanced budget without tax increases or eligibility restrictions, FSSA will need to look at several ways to ensure we continue responsibly managing the program,” he said.
It is very important that the ISMA represents the Indiana physicians and makes it crystal clear that losing doctors out of the Medicaid system will cause more patients to utilize the Emergency Rooms and will actually cost the State agency more money. This is not “Rocket Science” and it is very shortsighted thinking on the legislative side.
It will be very important for physicians and the ISMA to let them know how many physicians they will potentially lose.
The memo regarding this proposal can be read here.
In an effort to reach a balanced budget, Gov. Daniels asked each state agency to rein in spending for the next fiscal year. Doing its part, the Family and Social Services Administration (FSSA) presented a budget that proposed paying health care providers 95 percent of the fee schedule per claim, beginning July 1, 2009.
It was in the Fall of 2007 that physicians were told the Medicaid reimbursement rates would increase by about 1.5 percent. This was the first increase physicians had since the early 1980’s.
This proposed 5 percent holdback will result in a net decrease of 3.5 percent in July. This will not be acceptable to physicians and many of us will just stop seeing Medicaid patients completely.
“It is unfortunate that the current state of the economy is forcing Medicaid to take the extreme action of a 5 percent holdback,” said Michael Rinebold, ISMA director of Government Relations.
“The process to implement the changes does not require legislation, but it will require administrative rulemaking, which is expected to be completed within six months.”
Jeffrey M. Wells, M.D., director of Office of Medicaid Policy and Planning, hoped the provider rate withhold could be avoided but, said it is critical that the agency plan for the worst. “With the recent revenue forecast showing challenging economic times ahead and with the governor’s commitment to a balanced budget without tax increases or eligibility restrictions, FSSA will need to look at several ways to ensure we continue responsibly managing the program,” he said.
It is very important that the ISMA represents the Indiana physicians and makes it crystal clear that losing doctors out of the Medicaid system will cause more patients to utilize the Emergency Rooms and will actually cost the State agency more money. This is not “Rocket Science” and it is very shortsighted thinking on the legislative side.
It will be very important for physicians and the ISMA to let them know how many physicians they will potentially lose.
The memo regarding this proposal can be read here.
Labels: legislation, Medicaid
posted by Anonymous at 5:30 AM
5 Comments:
So...in these very difficult times when thousands of workers are losing their jobs, some their homes and many others seeing their pay and benefits cut, it is discouraging to read that doctors will refuse to treat Medicaid patients because of a 3.5% cut in reimbusements. Just curious--since government income is down significantly, just what else would you suggest being cut in place of these fee reductions?
how about the entitlement programs for the deadbeats that don't want to work.
We have enabled an entire generation to rely on the government to fix their problems.
By the way, how would you like to work and be paid less than you were in 1980?
Medicaid reimbursement is already dismal. I agree with Healthblogger. These patients will go to the ER, thereby increasing costs.
Daniels needs to think before he keeps cutting benefits and payments.
It's amazing to me how Daniels has 'overhauled' the system. As a health care provider, we see patients who have come thru trauma and have had catastrophic illnesses. The only way for them to receive chronic medical care is thru the Medicaid system. Recently, I had to enroll my son in the system. You see, he has chronic health conditions and is trying to attend college. The problem is, he has difficulty attending full time because of an additional problem, a learning disorder. Not attending full time equals not being allowed coverage on our insurance. Not being allowed coverage means no funding for his expensive medications ($2500 per month, just for one of his meds). See a vicious cycle here? No meds, no quality of life, no attendance at college. Full time college, possible failure in classes. No wonder so many give up. We had to get a senator involved to get him coverage, but as soon as he turned 19, he was kicked out of the system and made to reapply. Going thru this arduous process as an educated person has made me humbly aware of what the average disabled person must go thru to even try to get coverage. I agree that there are many deadbeats in the system, but what about those who could become contributing members of society if the system were in place to assist them?
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