Medi-Cal cuts 9.5% from radiology fees

California's state legislature resolved its budget stalemate lastmonth, but not before cutting 9.5% in Medi-Cal payments to radiologists,anesthesiologists and surgeons. The last-minute addition to thestate's budget bill is expected to save about $7 million.

The cuts were an unexpected--and unwelcome--surprise to stateradiologists, said Robert Acherrmann, executive director of theCalifornia Radiological Society (CRS) in Sacramento.

"There were many things on the table during budget discussions,but this was not one of them," he said. "The last versionwe knew about included cuts to surgery, anesthesiology and psychiatry.In a last-minute switch, psychiatry became radiology," hesaid.

Although the cuts may aid a beleaguered state budget, theywill not make it easier for radiologists to provide services toMedi-Cal patients, he said. As it is, the program pays only about40% of the cost of exams to providers.

The cuts will be figured into professional fees paid to thethree groups of specialists. The Medi-Cal program uses a schedulebased on the Health Care Financing Administration procedure codes,with an allowable amount for each procedure.

Physicians in the state have been struggling for years to balancethe needs of Medi-Cal patients with the scanty reimbursement theprogram provides. With the exception of payments to ob/gyns, Medi-Cal reimbursement has not been increased since 1985, he said.

The situation worsened this summer, when California's budgetcrisis forced physicians to accept state warrants instead of checksfor payment. In the final month of the stalemate between legislatorsand Gov. Pete Wilson, some physicians had stopped performing electivesurgery on Medi-Cal patients, and others announced they wouldnot accept new Medi-Cal patients.

Acherrmann expects the new cuts to hit radiologists hardestin metropolitan areas and other regions with a substantial percentageof Medi-Cal patients.

"The reimbursement is already below some radiologists'costs," he said. "But practice dictates that to maintainyour referral base you take referrals for Medi-Cal patients aswell as other patients from the same physician."

The CRS is hoping the cuts are short-term, and that reductionswill be restored if state revenues improve. But Acherrmann ispessimistic.

"It has obviously been a difficult year for the state,and there is not a lot we can do about it," he said. "Butas with a lot of other Medi-Cal services, I think we're goingto be seeing more and more people disenfranchised from the health-caresystem."