Stanislaus County Clinics Hope for Reimbursement Hike
Stanislaus County expects a decision from CMS in three to five weeks to approve a change in classification of its clinics that would increase reimbursements for Medi-Cal and Medicare services, the Modesto Bee reports.
County CEO Rick Robinson said the Health Resources and Services Administration last week notified the county that it was recommending Federally Qualified Health Center Look-Alike status for the county clinics.
About 60% to 70% of patients at the six clinics are Medi-Cal or Medicare beneficiaries. Officials said Medi-Cal reimbursements have not fully covered the cost of services, contributing to large deficits in the clinic system.
As a result, the county is considering reducing health services for tens of thousands of Medi-Cal patients unless the reimbursement rate changes.
If the classification is approved, payments would be based on the costs of services instead of fixed rates. Medi-Cal reimbursements for the clinics range from $50 to $115 per visit, generating as much as $6 million in additional payments for the county (Carlson, Modesto Bee, 8/10).