Questions About Proposed Fees Linger for Doctors, Hospitals
Health care providers are busy studying the implications of Gov. Arnold Schwarzenegger's (R) health care reform plan, calculating how much Medi-Cal reimbursement rates would have to increase to offset proposed new fees, the Sacramento Business Journal reports. Medi-Cal is California's Medicaid program (Robertson, Sacramento Business Journal, 7/23).
Under the governor's plan, hospitals would pay 4% of operating revenue to the state in return for higher Medi-Cal reimbursement rates (California Healthline, 2/5). Physicians would face a fee based on 2% of their revenue.
Medi-Cal chief Stan Rosenstein said Schwarzenegger's proposal calls for increasing Medi-Cal reimbursement rates by:
- 60% for hospital outpatient programs;
- 37% for physicians;
- 27% for hospital inpatient programs; and
- 24% for Medi-Cal managed care plans.
According to the Business Journal, UC hospitals and other facilities that treat large numbers of uninsured patients and Medi-Cal beneficiaries would benefit most under the proposal. Kaiser Permanente would be hit by a significant jump in fees but could benefit from a possible expansion of Medi-Cal managed care plans and an upswing in people buying health insurance, the Business Journal reports.
The California Hospital Association last week restated its opposition to the plan, citing the wide variation in how hospitals would fare under the proposal.
Meanwhile, the California Medical Association has not taken an official stand on Schwarzenegger's reform proposal because it has not been introduced as legislation.
While physicians and hospitals sort through the governor's plan, counties also are considering how it would affect their responsibilities for providing health care services for the uninsured and possibly undocumented immigrants (Sacramento Business Journal, 7/23).
Gov. Schwarzenegger's health care reform plan "is workable and less of a burden than other alternatives," although "it is critical for the governor's or any other health care plan to get the support of two-thirds of the Legislature," an Oakland Tribune editorial states.
Because a court could find the proposed fees to be taxes -- which would require two-thirds approval in the Legislature -- the editorial urges opponents of the governor's reform plan to "reconsider their position" (Oakland Tribune, 7/21).
