NCMS Opposes Medicaid Rate Cuts

With all the focus on Medicaid reform over the past few months, the 3 percent rate cut to doctors seeing Medicaid patients has been little discussed.  Then today, on the first day of the legislative session, Gov. Pat McCrory said he is recommending the legislature eliminate the cut due to difficulty in implementing such a withhold and shared savings provision from last year’s budget.  Until this point, no one had suggested eliminating the cut despite efforts by the North Carolina Medical Society (NCMS)  to protest the move to NC Department of Health and Human Services Secretary Aldona Wos and to the Centers for Medicare and Medicaid Services (CMS). The administration has not produced plans for how any portion of the reduced reimbursement could be earned back.

Meanwhile, legislators have chilled to the idea of a full blown Medicaid reform during this short session because of a lack of confidence in the NC Department of Health and Human Services (DHHS) as well as a belief the administration’s current proposal to move to risk-based, accountable care organizations does not go far enough toward reform of the program.   This is cause for great concern. The Medicaid budget is facing a projected shortfall of between $50 million and $150 million while many legislators believe Medicaid overruns from previous years limit their ability to fund other budget priorities.

Together this adds up to a high potential for more rate cuts on top of the 3 percent cut just implemented by DHHS.  The North Carolina Medical Society (NCMS) is concerned that efforts to solve Medicaid management issues coupled with rate cuts will have a devastating effect on the number of physicians participating in the Medicaid program and care for those North Carolina citizens who qualify for state assistance will be less accessible.  NCMS’ Medicaid reform plan offers a way for lawmakers to achieve more predictability over time while simultaneously improving the quality of care and reducing the overall cost of the program’s per member / per month expenditure.

Now is not the time to cut rates as an easy solution to short-term problems.  NCMS strongly opposes any rate cuts.  The time is right to take a significant step forward in reforming the overall system.   Patients deserve the best care, delivered in a timely fashion.  The state deserves the best value.  Our plan provides for that future.  Read more about our proposal.


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