L.A. County may further cut reimbursements to doctors treating uninsured patients

Emergency room doctors and on-call specialists treating uninsured patients at private hospitals in Los Angeles County could see county payments slashed under a proposal before supervisors today.

The rate cuts could force private hospitals to close emergency rooms, sending more patients to crowded county hospitals, officials said.

L.A. County reimburses doctors 27% of the cost of providing care to the uninsured during their first three days of care at private hospitals. Under the proposal, that reimbursement rate would be reduced to 18% as of July 1. Supervisors last reduced the rate from 29% in January 2009.

About 4,700 doctors would see payments cut under the proposal, according to Carol Meyer, chief network officer for the county’s Department of Health Services. Under the new rate, doctors would receive 43% of what Medi-Cal pays for the same services.

“The health department has a $200-million deficit. The state’s not going to give us anything to fix it. There is no one to backfill,” Meyer said.

The county had expected to pay doctors with $9 million from the state’s Emergency Medical Services Appropriation. But state lawmakers eliminated the fund, and as the number of uninsured grows, private doctors are expected to file more claims than ever with the county this year, Meyer said — an estimated 350,000.

“There’s no new source of funding to fill that gap,” Meyer said.

Doctors will likely look to hospitals to make up the difference, officials said. If they can’t, hospitals may lose doctors and be forced to close emergency rooms.

“It depends just how much pressure is put on those hospitals,” said Jim Lott, executive vice president of the Hospital Assn. of Southern California, “Some hospitals could be pushed over the edge by this.”

More than half of Los Angeles County’s 72 hospitals are operating at a deficit and two are in bankruptcy, Lott said. Countywide, 11 hospitals have closed since 2002, all of which had emergency rooms, he said.

Meyer said county officials consulted with doctors and hospital officials before proposing the rate cuts. But doctors said they would have appreciated more time to propose alternatives.

“It seemed like it happened all of a sudden,” said Dr. Robert Bitonte, president of the Los Angeles County Medical Assn. “It will impact indigent care, there’s no doubt.”

-- Molly Hennessy-Fiske

Comments

[Margo]

Well, how much more do Americans have to give up, before our elected officials realize that we cant keep pumping money and resources to lift the quality of life for non citizens, and maintain a progressive move forward for Americans especially low income and poor CITIZENS?

When will you stand up and make the hard choices for Americans best interest? We need you now more than ever before.......

[SeanBoy]

There may come upon a time when there will not be any health care option for U.S. citizen who are uninsured.

[TheBigPicture]

It's about time...

There is no reason we should subsidize the misfits of society...

Find employment with insurance and provide for yourself...Like most people in this country...

[Maxi3D]

Hey TheBigPicture let them eat cake right? May you never be unemployed, or love.

[pete]

Now, lets see. Insurance company makes 3 BILLION in profits in last quarter and hospitals are going down under. Who says capitalism doesn't work.

[Lornaj]

Why should we give care to non citizens? Americans have given up far too much for non citizens. Non citizens use ERs as their own personal doctor, and the citizens pay for their care.

[CHAWN]

I AM TOTALLY CONFUSED, I WORK ANDCONTRIBUTE TO THE SYSTEM BUT AS A CITIZEN LEGALLY I AM NOT AFFORDED BASIC HEALTHCARE AS PERSONS WHO DRAIN THE SYSTEM. POLITICIANS SHOULD GET OFF THEIR TAILS & TAKE CARE OF THEIR LEGAL CITIZENS AND KILL THIS POLITICALLY CORRECT CRAP. NONE OF US TAXPAYERS CAN GO ANYWHERE ELSE ON EARTH TO DEMAND WE ARE AFFORDED FREE HEALTHCARE& CASH BENEFITS. CUT THE SYSTEM FOR THOSE WHO WILL NOT CONTRIBUTE & HAVE NO LEGAL STANDING TO PROTEST THE CARE THEY FEEL THEY AREN'T ENTITLED TO. MAYBE JUST MAYBE THEY WILL GET IT. WE ARE BANKRUPT BECAUSE WE SPEND MORE MONEY ON ILLEGALS THEIR CHILDREN AND NOT TO MENTION ILLEGAL PRISONERS..I'M SORRY WHAT IS HOMELAND SECURITY FOR? AS TAXPAYERS OUR RESOURCES SHOULD BE CONCENTRATING ON THE CITIZENS BORN HERE, NOT THOSE WHO COME ILLEGALLY AND HAVE A SAD STORY.. PREACH IT 2 THE GOVERNMENT OF THEIR NATIVE HOMELAND IT IS NOT OUR PROBLEM..!!!! REMEMBER LAUSD & PROP187, WHATS THE PURPOSE IN VOTING WHEN LOBBYIST CAN DESTROY THE INTERPRETATION OF THE PEOPLES WILL AND SAY SCREW WHAT YOU VOTED FOR, YOU KNOW NOTHING.. WOW HOW REALITY HAAS THE PROPENSITY TO BITE YOU IN THE REAR. WE CAN NOT AFFORD IT!!!!!!