Budget Delays Will Halt Payments to Health Specialists, Hospitals
If, as expected, California lawmakers do not approve the fiscal year 2009 budget by July 1, none of the state's HMOs will receive Medi-Cal payments until a budget passes and likely will have to delay payments to specialists, hospitals and other health care providers, the Riverside Press-Enterprise reports.
Inland Empire Health Plan, which handles Medi-Cal coverage for nearly 350,000 low-income residents in Riverside and San Bernardino counties, has created a contingency plan to cover some of its expenses after it receives its last monthly $30 million payment on June 30. Medi-Cal is California's Medicaid program.
The health plan has taken out a $20 million line of credit for about $190,000 to stay afloat through August, the Press-Enterprise reports. After August, the HMO's board of directors will have to ask the San Bernardino and Riverside boards of supervisors for a loan until the budget passes, Brad Gilbert, the plan's CEO, said.
Gilbert said the plan will pay in full all of its primary care physicians and pharmacies regardless of what happens, although providers will have to wait for the additional payments they earn for services such as immunizations and prenatal care.
However, Inland Empire Health Plan will halt payments to specialists, hospitals and others until the state passes a budget, a move that could save the health plan $25.5 million through August, according to the plan's records.
Josie Gonzales, San Bernardino County Supervisor, said she worries some medical groups and physicians will choose to leave Medi-Cal and the health plan if they do not receive payments.
A group of the state's largest medical lobbying organizations has sued the California Department of Health Care Services to stop it from cutting 10% from Medi-Cal, or about $1.2 billion, to help balance next year's state budget.
Assembly member Bill Emmerson (R-Redlands) said he thinks lawmakers could save money by changing Medi-Cal services and eligibility rather than making systematic cuts (Hines, Riverside Press-Enterprise, 6/23).