Good News!

Gov. Reverses Decision Regarding Medicaid Fee Freeze

OOA Executive Director Jon F. Wills and his counterparts from the Ohio State Medical Association, Ohio Hospital Association, and Ohio Children's Hospital Association had a productive meeting with Gov. Ted Strickland and his top staffers on Tuesday, January 29, 2008, regarding the planned Medicaid fee freeze. Two days after the meeting, the Governor's office notified the associations that he had decided to reverse the freeze and give physician Medicaid providers a three percent line item increase starting in July (the first in seven years!).

The increase will be applied to codes that encourage patient care in non-acute settings as well as those. such as OMT. that are significantly less than 100 percent of Medicare.

In November 2007, Ohio's financial crunch led the Governor to indefinitely postpone plans to give Medicaid providers fee increases that were approved by the Ohio General Assembly.

During his January 31, 2008, news conference Strickland outlined $730 million in budgetary adjustments to counter revenue shortfalls, but called the OOA prior to the conference to say he was reinstating Medicaid fee increases for community health providers as a result of the meeting with the associations.

During the meeting with the Governor and his staff, OOA Executive Director Jon F. Wills presented the initial case for reversing the freeze for physicians and stressed that primary care physicians are in crisis. He commended the Ohio Department of Job & Family Services for the methodology that was going to be used to apply the increase and noted that current reimbursement levels for most CPT Codes under Medicaid are 60 percent or significantly less than Medicare reimbursement. He said physicians, who lose money on each Medicaid patient they see, would be reluctant to take new patients under expansion plans announced earlier this month. Wills also asked the Governor for a study to determine Medicaid patients' access to care.

All of the associations expressed concern about the effect Anthem's withdrawal would have on the Medicaid Managed Care Program, and identified problems involving prior authorization, drug formularies, and slow payment from Medicaid MCOs.

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