Thursday, June 4, 2009

Accupuncture, Chiropractic, Podiatric, Dental, Optometric, And Psychological Benefits Could Be Eliminated From Medi-Cal On July 1, 2009

In February 2009, Gov. Schwarzenegger and the state Legislature enacted a budget that eliminated the provision of nine Medi-Cal “optional benefits,” including adult dental, psychology, chiropractic, acupuncture, speech therapy, incontinence creams and washes, audiology, optometry and podiatry services. The defunding of optional Medi-Cal benefits is scheduled to take effect on July 1, 2009.

However, these cuts would not be enacted if California receives sufficient funds from the recently signed federal economic stimulus package. The final state budget package assumes that California will receive a conservatively projected $7.8 billion of federal revenue as part of the recently enacted federal stimulus package. The California budget bill contains a "federal revenue trigger" that could restore funding for optional Medi-Cal benefits. If the total revenue ultimately received from the federal government by April 1, 2009, exceeds $10 billion, cuts to these Medi-Cal services would be avoided.

There are some legal challenges to these proposed Medi-Cal cuts. For example, the California Primary Care Association and two of its member health centers, Clinicas Del Camino Real, Inc. in Ventura and Southern Trinity Health Services in Trinity, jointly sued the state of California last month to prevent the elimination of certain Medi-Cal benefits currently being provided by California’s Federally Qualified Health Centers (FQHCs) and Rural Health Centers (RHCs).

The lawsuit filed in Sacramento Superior Court seeks a writ of mandate preventing the state from eliminating Medi-Cal adult dental, chiropractic, optometry, podiatry, and psychology services when provided by an FQHC or RHC. Because these services are included in the definition of FQHC and RHC services under state and federal law, FQHC and RHC services are mandatory and not “optional” Medicaid benefits, the suit said. The plaintiffs in this lawsuit seek to have the matter heard and resolved prior to July 1.

Any questions or comments should be directed to: Tracy Green is a principal at Green and Associates, Attorneys at Law, in Los Angeles, California. They focus their practice on the representation of licensed professionals and businesses in civil, business, administrative and criminal proceedings, with a specialty in health care providers.


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