MEDI-CAL: Pediatric Advocates Call For Hike In Reimbursement Rates
Two pediatric advocacy groups in the state are pushing for California to double Medi-Cal reimbursement rates for children's health care services in order to preserve patient access to medical care. The American Academy of Pediatrics' (AAP) California District and the University Children's Medical Group (UCMG), "the largest pediatric specialty medical group in California," have joined together in calling for increased Medi-Cal rates. According to the groups, the state's Medi-Cal reimbursement rates are considerably lower than the national average for Medicaid reimbursements. In 1995, California spent an average of $873 per child on Medi-Cal, while Texas spent $1,365 and New York spent $2,582; the national average was $2,432 per child on Medicaid. Currently, the state reimburses a physician an average of $16.40 per child for Medi-Cal visits, yet the average pediatrician's cost for standard care is in excess of $35.
"It is becoming increasingly difficult for low-income children to gain access to quality medical care in California," said Dr. Lucy Crain, chair of AAP's California district. She said Medi-Cal reimbursement rates for physicians have been frozen since 1986, and, as a result, 80% of the pediatricians in California have been forced to either restrict or refuse new Medi-Cal patients. Dr. Alan Lewis, president of UCMG, noted that while "children represent 50% of the state's Medi-Cal population," their care is funded by only one-fifth of the Medi-Cal budget. "Unless the Medi-Cal reimbursement rates are significantly increased, our state is going to have a very serious problem providing quality medical care for these children," said Lewis. The groups also expressed concern that the state's upcoming Medicaid enrollment outreach effort will cause the dollars allocated to the program to be spread even more thinly. The issue will be discussed during a state Senate Budget Committee hearing on April 13 and during another committee hearing in the state Assembly on April 27 (release, 4/6).