Proposed California Budget Bill Would Give Medi-Cal Doctors a Raise

California lawmakers introduced legislation Monday that would allow $465 million in higher payments for doctors and dentists who provide publicly funded care.

The proposal is outlined in a budget bill and may reflect an agreement between Gov. Jerry Brown and top legislative leaders on a key sticking point in budget negotiations. But neither top lawmakers nor Brown commented on the proposal.

The lawmakers and Brown were divided on how to spend more than $1 billion from higher tobacco taxes.

Under Proposition 56, the increased tobacco taxes are supposed to help expand health services to low-income Californians. But there was pressure to provide higher reimbursement rates to dentists and doctors who serve the poor.

“The governor’s budget allows for a 2 percent increase in rates to those MediCal health care providers who are in managed care operations,” California Department of Finance spokesperson H.D. Palmer said. “That works out to more than $170 million additionally from the state’s general fund.”

Doctors and dentists have pressured Brown and lawmakers to use a portion of $1.2 billion in tobacco tax revenue to increase the payments they get for treating low-income patients on Medi-Cal. Providers and health care advocates have long said that low payments for doctors and dentists discourage them from accepting Medi-Cal patients, leading to long wait times to see a doctor in some areas.

The legislation did not satisfy doctors.

“On first glance this legislation raises more questions than it answers,” said Joanne Adams, a spokeswoman for the California Medical Association, which represents doctors. “We will provide more comment once we have thoroughly reviewed.”

The bill, AB120, would allow – but not require – up to $325 million for additional payments to doctors and $140 million for dentists, subject to a formula that would be worked out by the state Department of Health Care Services. The legislation would allow up to $800 million in total supplemental payments at the discretion of the governor’s finance director, based on economic and budget factors.

Monday was the last day for lawmakers to finalize spending decisions to allow for a 72-hour waiting period before the budget deadline Thursday night.Budget legislation was introduced in time to hit the target.

But lawmakers and the governor still appear to be resolving differences. Senate and Assembly leaders scheduled news conferences Monday to outline an expected deal with the governor, but they were repeatedly pushed back and eventually cancelled.

The cancelled plans to publicly celebrate a budget deal reflected the struggles of Brown and lawmakers to get used to a new rule requiring them to publish all legislation, including the budget, for 72 hours before a final vote.

The rule, approved overwhelmingly by voters last year, has forced Brown and lawmakers to negotiate on a compressed timeline, but also will give the public, lobbyists and even lawmakers more time to digest the plan.

An Assembly-Senate conference committee last week approved most pieces of a state budget that would largely preserve the status quo. It would boost spending on social services and higher education while expanding a tax credit for the working poor. Democrats hold a majority in both chambers, making it likely the spending deal will pass Thursday.

Republicans, who are in the minority in both the Senate and Assembly, have long complained that they’re forced to vote on budget and other important legislation pushed by Democrats before they’ve had time to wade through everything in the bill.

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