In the wake of an adverse court ruling last fall, CDA and other stakeholders are pursuing legal and legislative avenues to prevent implementation of a 10 percent reduction in Medi-Cal fee-for-service reimbursement rates, a reduction which if fully implemented would be retroactive to June 2011.
The fee reduction was part of a larger state budget deficit reduction agreement, and affected nearly all Medi-Cal providers. CDA has participated actively in the ongoing legal challenge to those cuts, and the Ninth Circuit Court of Appeals panel ruling upholding the reductions is under appeal.
Alongside those legal efforts, Sen. Ricardo Lara (D-Long Beach) has introduced Senate Bill 640, which would eliminate the state’s ability to implement the rate cut and prevent the state from “clawing back” years of retroactive payments from providers.
“The state’s attempt to cut reimbursement rates and re-claim payments already made would have a devastating effect on patients’ oral health and their ability to access care, by reducing the provider network at the same time that the Affordable Care Act will be increasing demand for services,” said CDA President Lindsey Robinson, DDS, a pediatric dentist. “SB 640 creates a mechanism for negotiations in the legislative arena to coincide with our ongoing legal fight. We appreciate Senator Lara’s willingness to take on this issue on behalf of all Medi-Cal providers.”