Medi-Cal the California Medicaid program is proposing cutting payments 10% and is also looking back retroactively to June 1, 2011 for recoupments.
This means that if you provided treatment to patients between June 1, 2011 and now, Medi-Cal will take back 10% of those payments. In simple terms it is like going to a restaurant for a cheeseburger today only to be told you owe an extra $.40 for the burger you bought back in June as the price for the past eaten cheeseburger has now been increased.
Of course there will be some legal actions and the subsequent fight but what about the principle of the idea. The Department of Health Care Services, DHCS noted that “there will be no appreciable impact on beneficiary access to providers after these reimbursement reductions.” Really, do you think providers are going to scramble for more Medicaid patients knowing that at any time the state can say “we changed our minds; you now owe us 10% of the payments that we paid you over the past four months?”