The Medicaid codes that have been protected will continue to be paid at 95% of Medicare. The other codes will be slashed to an average of 86.5% of Medicare rates. Hospitals that are not owned by the State of North Carolina will also be impacted with a 6% cut to their DRG.
The decision to go in this direction is in part out of necessity and in part an attempt to protect the already fragile Medicaid provider network. A vast number of billable services and providers are exempt due to legislative authority or federal funding stream before the targeted savings could even be discussed. The savings has to be made up with only nine months remaining in the budget year. This combination of exemptions and reduced timing has increased a 3% average impact to a nearly 5% average impact on the provider reimbursement rates.
NCMS and other physician groups have met with numerous state officials and offered complete accessibility to physicians for a dialogue about the proposed cuts. This level of cut to the provider rate services was not discussed in advance. NC Medicaid is providing just a one day notice of a cut that has the potential to end services for the most needy of our population. View the news release here.
According to the Department of Health and Human Services (DHHS) almost 2 million recipients receive needed health and medical services through this program. While some physicians may be able to choose whether to serve the Medicaid population, other physicians carry a disproportionate share of indigent patients within their medical practice. This impact is most often felt in the rural areas of North Carolina. Physician offices in those areas are dependent upon these rates to provide adequate staff and up-to-date technology and services to their patients. When cuts like those announced by DHHS today, physician offices with a majority of Medicaid patients will be faced with closing their doors and sending those patients to the local emergency department or to other providers in the more urban areas. Either way, patient care for the poor will be damaged.
The NCMS strongly opposes this cut. NCMS needs you to carefully analyze the codes that are attached and provide us with the real life stories of how physicians and your patients will be impacted. We need to hear from you directly in order to accurately portray this impact. Please direct your comments to Chip Baggett at firstname.lastname@example.org