Physicians Pressure State for More Medicaid Dollars
Physicians Pressure State for More Medicaid Dollars
Sacramento, CAMedicaid payments to California emergency physicians will be fatter by some $13.6 million beginning Jan. 1, 1998.
Bowing to pressure from the state’s providers, state lawmakers broke with a 20-year tradition and augmented payments to all hospital-based emergency and on-call physicians paid under Medi-Cal, the state’s $18.7 billion-a-year Medicaid program.
The legislature augmented physician payments by 20%, in effect restoring an amount automatically cut each year from a physician-payment formula within the Medi-Cal budget. In 1976, lawmakers instituted the cut to reflect the lack of overhead faced by emergency physicians in hospitals. The cuts have been implemented annually ever since.
But this year, physicians argued successfully that hospital-based providers incur overhead costs in the form of indigent care and contractual allowances. The amount of the increase comes to $6.8 million, which is the state’s share before federal matching funds raise the total to $13.6 million.
However, the increase still falls short of covering many overhead costs, according to the California chapter of the American College of Emergency Physicians (CAL/ACEP) in Sacramento.
Fifteen-year-old Wrongful Death Case Goes to Trial
St. Louis, MOAttorneys are scheduled to appear in court next month in a 15-year-old negligence suit involving an uninsured pregnant woman who was found by a hospital cleaning woman alone and hemorrhaging near the emergency department (ED) of the local public hospital.
Rosalyn Hammond originally sued Barnes Jewish Hospital (then known as Jewish Hospital) in 1982 for malpractice after giving birth to her stillborn child during the incident. Also named in the original suit were two physicians at St. Louis City Hospital where Hammond was found in an advanced state of vasa previa.
According to the complaint, Hammond was transferred from Jewish to St. Louis City, the public hospital, after physicians at Jewish allegedly decided not to treat her due to her complicated pregnancy and lack of insurance coverage.
The suit against Jewish was settled in 1995. But one of the two physicians who worked at St. Louis City still faces a wrongful death suit. The complaint charges that the physician, an obstetrician, verbally accepted Hammond’s transfer from Jewish but then failed to follow up on her treatment.
The city attorney representing the obstetrician argues that permission was never officially granted for Hammond’s transfer and that a patient-physician relationship did not exist at the time.
Should Physicians Code for Their Administrative Work?
Chicago, ILProfessional coders are skeptical that a proposal will succeed to create new procedure codes for the mounting administrative work that typically plagues physicians.
The American Medical Association’s House of Delegates recently tabled a proposal to create new CPT-4 codes in the Physicians’ Current Procedural Terminology manual to cover administrative duties such as paperwork and telephone calls.
Physicians, especially those in the emergency department (ED), have longed complained that they have been dogged by the amount of administrative work linked to patient care.
Reluctant to talk about the issue out of concern that their comments could influence the AMA’s decision, coders nevertheless feel that creating separate administrative CPT codes would be redundant.
"A lot of what physicians do are already reflected in the evaluations and management codes and built into the Medicare practice expense relative values," according to one coder. The AMA says its wants to study the issue further before taking action.
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