Healthcare providers struggling with state reimbursements |

Healthcare providers struggling with state reimbursements

Low cost clinics and doctors serving patients with Medi-Cal across the state have not received reimbursements for the past two weeks, some local healthcare professionals said Wednesday.

The situation has caused one Nevada County clinic to take out a loan because of cash flow problems.

As legislators in Sacramento wrestle to agree on the state budget for the current financial year, healthcare providers serving Medi-Cal patients are simply not getting paid.

A 10 percent reduction in Medi-Cal reimbursement rates went into effect last month in an attempt to balance the state budget. The 10 percent cut could remain in effect under the new budget unless lawmakers decide to do otherwise.

The California Healthcare Association estimates these cuts in healthcare will add a million more people statewide to the ranks of the uninsured; half of whom will be children, Craig Wilcox, a spokesman for the Sierra Nevada Memorial Hospital said. In Nevada County, the cuts will impact more than 9,000 people with Medi-Cal, Cynthia Bryan, with the Nevada County Social Services estimated.

“With cuts in Medi-Cal, fewer physicians in the county will accept Medi-Cal patients,” Wilcox said. “So more people will end up getting their primary care in the emergency room. The more crowded the emergency rooms, the longer the wait time for everyone, even those with insurance coverage. That’s not the highest quality of healthcare.”

The Miners Family Health Center clinic in Grass Valley, that receives 60 percent of its reimbursements from Medi-Cal, is being forced to take a loan from Citizen’s Bank to meet its expenses, Scott McFarland, CEO of the clinic said.

“The state is taking money from the poorest of the poor,” McFarland said. “(The cuts) will increase visits to the emergency room and it’s going to tax primary care physicians in our community. It may make them extend their scope of practice (as they treat people who don’t qualify for specialty services).”

The dental care program offered by the Sierra Family Medical Clinic on the Ridge is worst hit by the cuts, said Dr. Peter Van Houten, founder and medical director of the clinic.

“At this point, we haven’t turned anyone away but it’s definitely a concern for us because we can’t continue to offer dental services to patients if we are not being reimbursed,” Houten said. “Our dental services include a large number of children … as part of our Bright Smiles program with the school.”

Sierra Family Medical Services did receive an installment of payments from Medi-Cal last week which may have come from older claims, Van Houten said.

Sen. Sam Aanestad (R- Grass Valley) urged the legislature Wednesday “to take immediate action to restore reimbursement rates for all Medi-Cal providers.”

“We cannot expect healthcare providers to provide services at a loss, yet that’s exactly what’s happening,” Aanestad said. “In response, those providers are making tough decisions that include not accepting new Medi-Cal beneficiaries and cutting hours.”

Aanestad referred to the demise of the Lutz Center in Grass Valley and Health for All in Auburn which closed recently due to financial constraints to illustrate how budget cuts were affecting healthcare. He also referred to a hospital in Oakland that reduced its staff members and programs due to low reimbursement rates from the state.

To contact Soumitro Sen, e-mail or call 477-4229.

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