May 9, 2011 | Comments Off on Health Centers
Posted by Frank Ciesla
The Centers for Medicare and Medicaid Services, as you will see in the proposed regulations published Friday in the Federal Register, is attempting to establish criteria for assuring access to Medicaid services.
This proposed regulation has already drawn comments from various state officials as reported on Tuesday, May 3, 2011 in the New York Times. They are significantly concerned with the administration’s approach and are seeking to have the administration work with the States in implementing the Medicaid program. As we all are aware, under the Patient Protection and Affordable Care Act (PPACA) there will be a significant expansion of the Medicaid program and further, as set forth in a prior blog, PPACA mandates an increase in payments to primary care physicians. Neither the federal legislation nor the proposed regulations provide the States the funds necessary to upgrade the payments through the Medicaid program.
New Jersey is close to, if not the lowest state in Medicaid payments to physicians. As we are aware, many of the Medicaid patients are now seen in government funded health centers. Under Governor Chris Christie’s proposed budget, there will be a 10 percent cut in payments made by the State of New Jersey to the Federally Qualified Health Centers (FQHCs). As stated in the Star Ledger of Thursday, May 5, 2011, “With a 10 percent rate cut, the North Hudson Community Action Corp. Health Center would lose $933,000, Grant-Davis [President and CEO of the Primary Care Association] said, ‘A 10 percent cut cannot be absorbed.’. . .” As we are all aware, the payments made to private physicians by the Medicaid program are significantly below the payments being made by the State of New Jersey, to the FQHCs.
The simple question is — where is the money going to come from to pay for these Medicaid services, whether provided in the FQHC or doctors’ offices.
It will be critical to see, especially for the State’s primary care physicians, how the funding will be created to fund the provision of services by the primary care doctors, to the Medicaid population. At the current time, there is no answer other than unfunded statutory and regulatory obligations.