California Lawmakers Cut Providers’ Rates

SACRAMENTO, Calif.

A budget that passed the California Assembly July 29, and was signed Aug. 9 by California Governor Gray Davis, would cut Medi-Cal providers’ rates by 5 percent effective Jan. 1, 2004, according to a bulletin from the California Association of Medical Product Suppliers.

While the budget allows a few exceptions to the rate cut, medical supplies are not among those exceptions, CAMPS explained. “The cut applies to medical supplies and pharmacies; however, it gives Medi-Cal the discretion to apply the reduction to [durable medical equipment].”

Furthermore, the budget eliminates DME providers’ ability to bill Medi-Cal for prosthetics and orthotics, and gives Medi-Cal the authority to base DME reimbursements on one of three methodologies: the current Medi-Cal allowable; a rate that does not exceed 80 percent of the Medicare allowable; or the guaranteed acquisition cost, plus a markup.

The budget also outlines “options” for altering reimbursements for unlisted DME, which include custom wheelchairs and modifications, CAMPS added. “CAMPS continues to negotiate with Medi-Cal on a potential reimbursement alternative for unlisted DME,” the association said. “The bill language allows us to continue discussions after the legislation is enacted.”

For breaking news, go to www.homecaremonday.com, the electronic news service of the home medical equipment industry.