President Patrick C. Breaux, MD
Nearly Two Years of Medicaid Cuts to Be Implemented This Fall
Facing a difficult economy and dwindling state and federal funding, the Department of Health and Hospitals (DHH) has been tasked with identifying and implementing cuts to its 2010-11 budget while trying to protect access to medical care, specifically the Louisiana Medicaid program. In addition, cuts to the 2009-10 Medicaid program budget have been identified and announced but not actually implemented. This means that DHH must now go back and collect those rate reductions from the August 2009 and January 2010 cuts. Each claim will be adjusted to reflect the amount the provider must pay back to the Medicaid program as a result of those delayed cuts.
DHH is unable to delay implementation of the rate reductions any longer, since budget savings associated with all of the reductions must be realized before June 30, 2011. All participating Medicaid physicians will be mailed a letter from DHH with the following details regarding the plan for implementation:
§ Each provider will see their total adjustment amount on only one of the midweek RAs, either on September 22, 2010, or October 6, 2010.
§ The adjustment balance will not be deducted from either of the midweek RAs. Instead, the balance will be divided and applied in equal amounts to the normal weekly RAs immediately following the midweek adjustment RA & continue through June 7, 2011. Any remaining balance after the June 7, 2011 RA must be paid in full by June 30, 2011.
§ Please note that the adjustment balance will equal the total adjustment amount less any adjustments for claims that encounter edits due to system changes since the claim initially paid. It is anticipated that there will be a minimal number of such claims so these will be resolved in each providers’ future normal weekly RAs.
Providers may contact Bureau of Health Services Financing to inquire about an alternative payment plan, request an estimated total dollar amount of the adjustment balance, or submit any questions. These inquiries may be submitted via e-mail to
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or written correspondence to:
Bureau of Health Services Financing
Professional Services Program
P.O. Box 91030,
Baton Rouge,
LA
70821
More information is available, including the Rate Reduction Summary and the Claims Adjustment Memorandum, on LA Medicaid’s Website:
http://www.lamedicaid.com/provweb1/Recent_Policy/Claim_Memo_RR.htm
Read the DHH Emergency Rules: http://www.doa.louisiana.gov/osr/emr/emr.htm
Medicaid Cuts – LSMS Physician’s Share Their Perspective
Earlier this summer, the LSMS requested that you share your experience by taking the 2010 Medicare & Medicaid Participation Survey. As of August 6, 386 physicians had answered the call. The results are telling:
§ More than half of respondents (56.6%) indicated that they have either stopped or will stop accepting new Medicaid patients; another 24.8% are considering this as an option.
§ A majority (69.0%) of respondents indicated that they have either limited or will limit the number of new Medicaid patients accepted by their practice; another 16.0% are considering this option.
§ 40.3% of respondents indicated that they no longer see or will no longer see any Medicaid patients; another 31.4% are considering this as an option.
§ When asked to indicate their experience in referring Medicaid patients for specialty care, respondents who chose “difficult to make referrals” and “almost impossible to make referrals”, the percentages are substantial: 94.9% in 2010 compared to 86.7% in 2009.
How Can You Make Your Voice Heard?
The LSMS wants to know… how will your practice be affected by the cuts? What actions will you take or have you taken to ensure the viability of your practice? In an effort to demonstrate how these cuts will further exacerbate access to quality medical care for all patients, especially those who rely on the Medicaid program, we ask that you share your experience with us by:
§ Calling 800.375.9508 or emailing the Department of Public Affairs at
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and we will connect you with a reporter in your area.
§ Taking the survey: http://www.surveymonkey.com/s/NN8JQ8Y
Component Society Forum, Board of Governors Scheduled to Meet
The Component Society Forum is scheduled to meet on Thursday, September 9, 2010, at the
Hilton
Capitol
Center in
Baton Rouge. The forum is a joint meeting with LSMS leadership, staff and PCMS officers and executives to share ideas and resources, and work together to maximize recruitment and retention efforts. Capital Area Medical Society (CapitalAMS), along with its President Dr. Paul Perkowski, will host the event. Dr. Susan Bankston, CapitalAMS President-Elect, will serve as moderator for the meeting.
The LSMS Board of Governors is scheduled to meet on Friday, September 10, 2010, at the LSMS Headquarters in
Baton Rouge. Please contact Executive Assistant Geraldine Leche at
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with any questions regarding this meeting.
Electronic Health Record (EHR) Incentive Programs Informational Teleconference
September 9, 2010 – 9:00 a.m. to 10:30 a.m.
The Centers for Medicare & Medicaid Services (CMS) Dallas Regional Office invites all interested healthcare professionals to participate in a toll-free teleconference about the EHR Incentive Programs. This call is for the benefit of Eligible Professionals interested in learning the specifics of the Medicare and Medicaid EHR incentive programs.
Date: Thursday, September 9, 2010
Time: 9:00 to 10:30 AM Central Daylight Time
Toll Free #: (800) 603 - 1774
Conference ID: 96020172
NOTE: In order to join this conference call, all speakers and participants will be required to provide the Conference ID listed above. Please call in 10 minutes prior to the call’s start time. Pre-Registration for this call is not required.
