State ends boosts in Medicaid fees


POSTED: Monday, July 06, 2009

Higher payments to Hawaii doctors serving Medicaid/QUEST patients have ended after one year.

The 2007 Legislature appropriated $8 million for 2007-08 and another $8 million for 2008-09 to raise the state's payments to the federal Medicare level for health care providers.

The Lingle administration withheld the funding for 2007-08, causing an uproar among health and physician groups concerned about access to health care for poor and low-income residents. Doctors were reported cutting back on their practice or leaving the state because of low reimbursements. Payments were increased for 2008-2009 with release of the state money and $10 million in matching federal funds.

But lawmakers wrestling with the state's budget crisis this year did not repeat the appropriation, and the higher payments ended June 30 with the fiscal year.

“;It's unfortunate,”; said Dr. Virginia Pressler, Hawaii Pacific Health executive president of strategic business development. A lot of doctors who did not understand the issue thought they were getting higher Medicaid fees, she said, “;and now they're getting cut when things are getting worse.”;

Doctors who see Medicaid patients “;are the dedicated ones,”; Pressler said. “;That's what's so unfortunate. They're taken advantage of.”;

She said $320 million in American Recovery and Reinvestment Act money coming to Hawaii for 27 months starting last October was meant specifically for Medicaid. But it is being used to patch the budget deficit, she said.

The Hawaii Medical Association has sent a survey to doctors to assess Medicaid issues and learn how many will continue serving Medicaid patients, said April Donahue, HMA executive director.

“;Anecdotally, they're not happy,”; she said. “;We testified in support of a bill that would increase reimbursements, but it did not go through.”;

The drop in payments will hurt a lot of physicians, but they will continue to see patients, she said. “;They don't feel they can turn them away.”; However, some might stop taking new Medicaid/ QUEST patients, she said.

Donahue said the HMA is working with the American Medical Association at the national level on various issues, including inadequate Medicaid reimbursements.

She said the HMA has sent letters to Hawaii's congressional delegation pointing out “;Medicaid has been particularly difficult. We hope to meet with them to see what they can do at the federal level.”;