There has been some media attention over the last few days paid to the fact that some Medi-Cal providers are not getting paid due to the late State Budget.  I thought it would be helpful to summarize the issue, and what it means for physicians.  Hopefully this will help you answer physician questions when they arise.

Every year, the State creates a $2 billion fund ($1 billion State + $1 billion Federal) called the Medi-Cal Provider Interim Payment Fund (MPIPF).  This fund pays institutional providers – clinics, skilled nursing facilities, adult day centers, etc. – while the State Budget is delayed.  Due to the fact that the State Budget has now been delayed for an inordinate amount of time, that fund is now depleted.  Those payments have stopped.

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 AB 2470 allows patients to appeal to state regulators if insurers cancel coverage for them after they get seriously ill    Sacramento – Legislation providing patients a vital safeguard to ensure the federal ban on rescissions is followed passed the Assembly today on a bipartisan vote and was sent to the governor’s desk.

AB 2470, authored by Assemblyman Hector De La Torre, D-South Gate, and sponsored by CMA, means plans cannot act as judge and jury whenever they want to cancel a policy. The Assembly vote followed the Senate’s approval of the bill on Monday. The governor has until Sept. 30 to act on it.

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Palmetto GBA has received the revised fee schedule from CMS with the 2.2% increase for services from June 1 through November 30, 2010. They are testing their system with the new fee schedule, and should have everything pricing correctly by this Thursday, July 1.

Palmetto has provided CMA with the following additional information on the previously held June claims:

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Elvis made history by leading the campaign for vaccination. The image of Elvis being vaccinated was made into ads and billboards. The rate of polio plummeted.

Now, more than 50 years later, we find ourselves with other epidemics that could be curtailed by vaccinations. The fear of immunizations is based on misinformation. Evidence from studies does not support an association with autism.

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A very contagious disease caused by a type of bacteria called Bordetella pertussis. Among vaccine-preventable diseases, pertussis is one of the most commonly occurring ones in the United States.

• Vaccines: Very effective but not 100 percent effective. If pertussis is circulating in the community, there is still a chance that a fully vaccinated person can catch it.

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