CSP Pushes to Repeal 10% Medi-Cal Provider Rate Cut

for Pathology/Lab

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The CSP has taken leadership in establishing a coalition of medical specialty societies and the CMA to repeal the current Medi-Cal 10% provider rate cut from 2011. The cut was made in 2011 at a time of large budget deficit that triggered a number of cuts to Medi-Cal and other state spending. It has continued at a time of massive state budget surpluses and Medi-Cal reimbursement is recognized as among the lowest rates in the US. Medi-Cal enrollment is now almost $16 million with 1 of every 3 Californians is on Medi-Cal.


The exemptions from the 10% cut has only been applied to certain types of services and is within the discretion of DHCS to exempt certain providers. To date most physicians services, including all pathology services, continue to be subject to the 10% reduction.


CSP has submitted requests for consideration of elimination of the Medi-Cal cut to both Budget Sub-Committees of the Assembly and Senate. There are many requests to use state surplus funds and the budget process will now include a May Revise from the Governor that includes updated current budget year expenses and revenues and then adoption of each House’s version of the budget in May.

CSP Supports To mandate Coverage for Biomarker Testing

The CSP is in support of SB 912 (Limon) to mandate health plan and insurance coverage for biomarker testing. Advances in biomarker testing and cancer treatments mow allow for targeted cancer therapies that can improve patient survival and quality of life. Testing patients for specific biomarkers is integral to precision medicine in cancer care. Some plans and insurers do not follow clinical practice recommendations.

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