Medi-Cal Doctors Take Pay Cut

On Tuesday, July 1, California doctors treating people on Medi-Cal – which is the federal-state health insurance plan for the very poor known elsewhere as Medicaid – began receiving 10 percent less for their services. However, Santa Barbara’s Medi-Cal physicians will get a reprieve as they are paid by the Medi-Cal-managed care program TEXTCenCal Health. Like other Medi-Cal managed care plans, CenCal Health gets more leeway from the state for its reimbursement systems. The pay cut was enacted in February by Governor Arnold Schwarzenegger as part of his emergency deficit reduction package. Santa Barbara dentists who treat Medi-Cal patients will not dodge the pay cut, as they are paid through a separate program known as Denti-Cal.

Bob Freeman, a spokesman for CenCal Health, said the organization isn’t going to reduce payments to providers at this time. “Everything is staying the same,” he said. But he did not say how long CenCal Health would be able to avoid decreasing its physicians’ pay, as the 10 percent reduction in reimbursement to Medi-Cal providers signed into law does, in fact, apply to Medi-Cal managed care plans like CenCal health. The Santa Barbara program, which operates in San Luis Obispo too, is simply choosing for the time being to use its reserves in order to maintain its payment levels to contracted doctors.

Health advocates around the state are worried this pay cut will push even more physicians out of the Medi-Cal program, which already has one of the lowest payment schedules in the entire 50-state Medicaid system. The fewer physicians that participate in the program, advocates say, the less access Medi-Cal enrollees have to care.

Robert Poulin is a Santa Barbara ophthalmologist whose practice, Associated Eye Specialists Medical Group, is comprised of between 5 and 10 percent Medi-Cal enrollees. Poullin said Medi-Cal’s low reimbursement rate and high paperwork requirement means he spends more on these patients than he takes in. Even if the pay rate remains the same, he said, he might at some point just start seeing Medi-Cal enrollees for free. “It does have an effect because there’s less money coming in and at certain point you have to look at it as charity care,” Poullin said.