We need your help to prevent harmful cuts to Medicaid’s reimbursement of physicians. Take Action Below!

It’s no secret that Ohio’s physicians have disproportionately borne the brunt of stagnating Medicaid reimbursement for the last 10-20 years.  Over the past 10 years, inflation-adjusted Medicaid reimbursement for physician services in our state actually declined by 27%, while other health care providers made gains.

Now, the state’s Executive budget is proposing to modestly increase Medicaid’s primary care reimbursement rates for physicians seeing traditional Medicaid patients, but that increase would be paid for by decreasing physician reimbursement rates for seeing dual-eligible patients and by cutting funds for physician training (GME).

Essentially, a physician rate cut would pay for a physician rate gain.

It’s equally alarming that the proposal to increase reimbursement for seeing traditional Medicaid patients only raises rates for 33 codes, and it only increases their reimbursement rates to 65% of Medicare levels.

We need your help to tell legislators that this proposal is unacceptable to Ohio physicians and patients.

The OSMA reports that physicians across the state might be forced to significantly limit the number of dual-eligible patients they see if the proposed cuts are realized.  If the cuts go into effect, patients with dual eligibility could have trouble accessing care, just as patients with traditional Medicaid already do.

It’s your turn to take action.

Please contact these key Ohio House Representatives who have the ability to impact Medicaid’s budget.

Call their offices TODAY!

Rep. Robert Sprague, Chair, House Finance Subcommittee on Health: (614) 466-3819
Rep. Emilia Sykes, Ranking Member, House Finance Subcommittee on Health: (614) 466-3100
Rep. Barbara Sears, Chair, Joint Medicaid Oversight Committee: (614) 466-1731
Rep. Mark Romanchuk, Member, House Finance Subcommittee on Health: (614) 466-5802
Rep. Nickie Antonio, Member, House Finance Subcommittee on Health: (614) 466-5921
Rep. Ryan Smith, Chair, House Finance Committee: (614) 466-1366
Rep. Cliff Rosenberger, Speaker of the House: (614) 466-3506

Tell them to:

• Get rid of the proposed cuts to dual-eligible and GME payments
• To further increase Medicaid physician reimbursement rates to 100% of Medicare rates

Make it clear: Ohio physicians should be adequately reimbursed by Medicaid for the vital care they provide to low-income patients.

Have a few extra minutes? Please contact your local legislators with the same information!

To find your representative’s contact information, visit http://www.ohiohouse.gov and use the “Member Search” tool in the bottom left corner of the page.

Details:

The Executive Budget Proposal would:

1. End cross-over claims for practices that serve dual eligible patients in 2016-2017. This means instead of being paid 100% Medicare rates for seeing these dual-eligible patients, physicians will be paid the maximum Medicare allowable charge. Without a co-payment from Medicaid, this is generally 80% of Medicare.
2. Modestly Increase reimbursement rates for 33 primary care and E&M codes in 2016-2017.

If you get someone on the phone, here’s what you can talk about:

1. Physicians – both in primary and specialty care – will have to make tough decisions about the number of dual-eligible patients they can see because of this proposal.  There WILL be physicians who decide to limit and eliminate the care they provide to dual-eligibles.
2. The new primary care rates don’t do nearly enough to increase access to care for Medicaid patients, and that failing to maintain adequate payment rates (such as those that were in place in 2013-2014) will force physicians to limit the number of Medicaid patients they can take.  We know that 100% of Medicare rates would actually have a positive impact on access.
3. Inflation-adjusted rates for Medicaid physician reimbursement have significantly decreased over the past 10-20 years, while the cost of running a practice has stayed steady with inflation.  This disparity means that continuing to see Medicaid patients at more and more of a loss each year.
4. High-quality physician care for Medicaid patients can save the program from paying for long-term, expensive care in the future.  It is responsible to invest in paying physicians now to prevent costs down the road.

Thank you.

Laxmi S. Mehta, MD, FACC
President