CMA Warns Lawmakers Away From Governor’s
Proposal to Expand Medi-Cal Managed Care
[Posted 03/03/05]

CMA last week told the Senate Budget and Fiscal Review Committee that the governor’s plan to expand the Medi-Cal Managed Care Program would disrupt patients’ relationships with their current physicians and could potentially restrict access to care and increase reliance on costly emergency room care.

The governor in January released his proposal to “redesign” Medi-Cal. The proposal would, among other things, expand the Medi-Cal Managed Care program to 13 new counties, affecting 262,000 enrollees in El Dorado, Placer, Imperial, Madera, Merced, Marin, Mendocino, San Benito, San Luis Obispo, Sonoma, Ventura, and possibly Kings and Lake counties. The proposal would also require an estimated 554,000 elderly and disabled beneficiaries to enroll in Medi-Cal managed care.

Testifying on behalf of CMA were Ted Mazer, M.D., a CMA trustee, and Patricia Samuelson, M.D., a member of CMA’s Medi-Cal Technical Advisory Committee. Drs. Mazer and Samuelson told committee members that unless sweeping changes are made in how Medi-Cal managed care networks operate, the governor’s plan would disrupt long-standing physician-patient relationships, further restrict patient access to specialists, and place unsustainable financial burdens on physicians who provide care to children, the disabled, and the elderly poor.

“High administrative burdens and hoops to jump through and unsustainably low rates of reimbursement, coupled with complex arrangements of subcontracting entities through which network physicians are accessed,” will only reduce the number of physicians who can afford to treat Medi-Cal patients, said Dr. Mazer.

Contact: Lisa Folberg, 916/444-5532 or lfolberg@cmanet.org.