Isn't there a provision in the ACA that medi-cal rates have to be brought up to match at least the Medicare rates?

Rudy, Thanks. I hope DMHC and our legislators are aware of the scope of the problem. I can see how this oculd happen in CA. with the Presumptive Eligibility enrollment processes and how some of the county level enrollment takes place.

Frank, Federal Expenditures on Illegal Aliens Reported for: 2010
medical emergency medical care $250,000,000
fraudulent use of medicaid $1,235,000,000
medicaid cost of childbirth $1,238,100,000
medicaid for children $1,626,800,000
other medical outlays $1,600,000,000
Medical Subtotal $5,949,900,000. In California total Expenditures of Illegal Aliens costs $21,756Million in 2010.

Rudy, can you explain, apart from the CPSP and other special programs for ER care and Breast cancer how illegal folks are covered by MediCal? Is there falsification taking place by enrollees and those responsible for enrolling them (Local County workers)?

Chris Stenrud, executive director of advocacy and public affairs for Kaiser Permanente, said the finances of the move may not work well for Kaiser but ensuring continuity of care for so many California kids is important to the organization.

"From our standpoint, it's about keeping the members, this keeps those 193,000 children in our system," Stenrud said. "Ultimately, it is to some degree part of our not-for-profit mission, to provide care in the community for those who can't afford it."



Read more: http://www.californiahealthline.org/capitol-desk/2012/7/kaiser-nears-deal-on-healthy-families-kids.aspx#ixzz20SBWIDNB

The reality is that the majority of the folks that will entering (or now qualified) for a Medicaid program are "Hispanic" legal and illegal; I wonder how the rest of America will feel about footing the bill the Trillion dollar price tag for Medicaid? We definitely live in "interesting times"...

Rudy Lehder Rivas, President
Hispanic Consultant for Medicaid

http://www.hispaniconsultant.com/

Yeah, I spent lots of years getting a PhD and I make $50,000/yr. Some people aren't in it for the money--the incentive is helping people. Your point is well taken, though Hatti, that there's a shortage of physicians and med school is expensive. More programs like the National Health Service Corps loan forgiveness program would help.

Susan misses the point. Everyone acknowledges that we are running short of primary care docs, especially given the rise in chronic conditions such as diabetes II and obesity and the health concerns they create. Yet with such ridiculously low reimbursement rates, what is the incentive to spend all those extra years and graduate from medical school with hundreds of thousands of dollars of debt? Who can blame doctors who don't want to accept MediCal patients--the more they take, the more they lose! In many cases the cost of care actually exceeds the doctor's cost of providing it!

There is a proposed rule out from DHCS that would increase medicaid reimbursement to medicare levels for private doctors. That is approximately double the current reimbursement in CA. The funding is only for two years, the question is how to incentivise doctors once the funding runs out.

Folks, the Federally Qualified Health Care system has been gearing up for this increase for the last few years. Find the nearest clinic at the link below. Yes, there will no doubt be wait times when health care reform kicks in, but we do people a disservice to imply that they need to find a private physician who takes Medi-Cal. All FQHCs take Medi-Cal.

http://findahealthcenter.hrsa.gov/Search_HCC.aspx

The same will hold true for dentists and access to dental services; most now do not participate in Denti-Cal, primarily because of inequitable rates. We will be releasing new DDS-Denti-Cal participation findings in the fall.