California Court Allows Cuts in Doctor Fees

Doctors nationwide were relieved when Congress rolled back a scheduled 10% cut in Medicare fees. But doctors in California are still facing a 10% cut in the fees paid by Medi-Cal, the state’s Medicaid program.

Last month, a California Superior Court judge threw out a request for a preliminary injunction that would have prevented the reductions from taking effect. The cuts are part of an effort by the California legislature to rein in the state’s ballooning $17 billion deficit.

In the ruling, the court acknowledged that the lower fees would make it harder for the poor to get care, but maintained that the group of California healthcare providers that filed the suit should pursue redress with the federal government, not the state. The coalition vowed to continue the fight in both state and federal courts. The original suit had been filed in state court, went to federal court, and was sent back to state court.

Medi-Cal, which covers 6.6 million low-income state residents, already has one of the lowest reimbursement rate schedules in the country and spends less per enrollee than any other state Medicaid program. If the fee reductions are not rolled back, a doctor will get $21.60 for a basic patient visit, down from $24. According to the California Medical Association, a doctor needs $30 to $35 per visit just to break even.