The CSP has continued to push both the Assembly and Senate Budget Sub-committees to request elimination of the 10% Medi-Cal Provider rate cut that has been in place since 2011. The cut began in the midst of the recession that caused a $25B shortfall in the State Budget. Some providers have now been exempted from the cut but relief to the physician community has been very narrow targeting only a handful of physician office visit codes and some pediatric services.
Last week the Assembly Budget Sub-Committee adopted a provision to eliminate the 10% Medi-Cal cut and that issue now will go to the Joint Conference Committee that will adopt a final version of the state budget to send to the Governor.
The Senate Budget sub-committee adopted a provision that eliminates that Medi-Cal pay no more than 80% of Medicare for laboratory services. Since Medi-Cal adjusted their rates previously based upon review of private payer rates it is no longer fair to additionally reduce rates based upon the 80% of Medicare methodology. In addition the pending PAMA implementation could further impact the applicable Medicare rate.
The budget must be adopted by June 15th so we will know the outcome in a few weeks