Saturday, December 7, 2013

California Obamacare Exchange Insurance: A Bridge to Nowhere?

‘An estimated seven out of every 10 physicians in deep-blue California are rebelling against the state's Obamacare health insurance exchange and won't participate, the head of the state's largest medical association said.

“It doesn't surprise me that there's a high rate of nonparticipation,” said Dr. Richard Thorp, president of the California Medical Association.’

‘California offers one of the lowest government reimbursement rates in the country -- 30 percent lower than federal Medicare payments. And reimbursement rates for some procedures are even lower.

In other states, Medicare pays doctors $76 for return-office visits. But in California, Medi-Cal's reimbursement is $24, according to Dr. Theodore M. Mazer, a San Diego ear, nose and throat doctor.

In other states, doctors receive between $500 to $700 to perform a tonsillectomy. In California, they get $160, Mazer added.

Only in September did insurance companies disclose that their rates would be pegged to California’s Medicaid plan, called Medi-Cal. That's driven many doctors to just say no.

They're also pointing out that Covered California's website lists many doctors as participants when they aren't.

“Some physicians have been put in the network and they were included basically without their permission,” Lisa Folberg said. She is a CMA’s vice president of medical and regulatory Policy.’

‘Dr. Sherry Franklin, a pediatric endocrinologist at Rady’s Children’s Hospital, San Diego, and at the University of California San Diego Hospital, isn't joining the exchange.

Franklin said last summer she "got a letter in the mail letting me know if I wanted to participate with Blue Cross through the exchange, which is different from my regular Blue Cross practice, because they are paying less. They did not tell me how much less. You had to agree or disagree. So, of course, I said no."‘

‘No one is more aware of this than Alex Briscoe, health director for Alameda County Health Care Services Agency, which includes Oakland.

“Enrollment doesn’t mean access, because there aren’t enough doctors to take the low rates of Medicaid,” he said. “There aren’t enough primary care physicians, period.” ‘ - Doctors boycotting California's Obamacare exchange, Washington Examiner, 12/06/2013

Link to the entire article appears below:

Related story regarding Medicaid and Medicaid reimbursement rates: George Will: Medicaid is Next Obamacare Crisis, 12/01/2013, Newsmax.

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