Sunday, October 21, 2018

RCMA/CMA's Advocacy Secures $1 Billion+ for Medi-Cal Providers

In 2016, and with a $1 million investment, the California Medical Association (CMA) led a coalition to take on Big Tobacco to improve access to care through Medi-Cal.

California voters overwhelmingly approved Prop 56, which added a $2 tax on tobacco products and stipulated that funds should increase access by improving provider payments. California's 2018-2019 state budget continues to provide over $1 billion annually to improve provider payments so more Medi-Cal patients can access care when they need it most. Other key investments include graduate medical education (GME) funding increases and school loan repayments.

What Does This Mean For Riverside County Doctors?
This supplemental funding affects both fee-for-service Medi-Cal as well as Medi-Cal Managed Care. Click Here to view a comparison of Prop 56 payments by year as well as how these new reimbursements compare to current Medicare Rates in Riverside County.

RCMA has been informed that Inland Empire Health Plan (IEHP) will be paying FY 2018/2019 at the enhanced rates, including the additional E&M codes, starting July 1, 2018. However, given the lag in encounter data and timing of payments, the first enhanced payments physicians will see this Fall will be 2017/2018 timeframe payments.  The first quarter payment for 2018/2019 will not be until early 2019.  

Look for further communication from IEHP in the next few weeks. Payments will be made directly to IEHP providers based on encounter submissions reflecting the E&M codes shown in the Rate Comparison Chart

For Further Information Please Contact:
Riverside County Medical Assoication
(800) 472-6204

or

Inland Empire Health Plan (IEHP)
(909) 890-2054
 


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