Few Affected by Medi-Cal Change at Simi Valley

Simi Valley Hospital's recent cancellation of its Medi-Cal contract has not significantly affected patient care, but the hospital has experienced some difficulties in transferring Medi-Cal patients to other facilities, hospital officials said, the Ventura County Star reports. Medi-Cal is California's Medicaid program.

The facility chose to no longer provide inpatient care to Medi-Cal enrollees because reimbursement rates did not adequately cover the cost of services, Gary Irish, president of the hospital, said. Simi Valley continues to accept Medi-Cal patients in need of emergency care.

Without the contracts, the hospital had planned to transfer Medi-Cal beneficiaries who need inpatient care to Los Robles Hospital & Medical Center in Thousand Oaks, the nearest facility that contracts with Medi-Cal.

Simi Valley has contacted Los Robles about twice a day since the contract was canceled, but the hospital has almost always been full, according to Jim Sherman, president of Los Robles.

When Los Robles is full, the patients are treated at Simi Valley. Medi-Cal reimburses the hospital on a fee-for-service basis rather than the contracted rate.

Sherman said that two beds were vacant last week, but Simi Valley was unable to locate doctors who accepted Medi-Cal enrollees, so the patients could not be transferred (Kisken, Ventura County Star, 12/19).