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State legislation that could improve OD reimbursement.
March 27, 2024
Last week, the American Optometric Association highlighted the possibility that California may soon be able to increase payment for ODs treating Medicaid patients.
The AOA featured an announcement about this in its AOA First Look newsletter, quoting an Associated Press story by Adam Beam.
“California Gov. Gavin Newsom and his Democratic allies in the state legislature have greatly increased the number of people on Medicaid, including all eligible adults in the state who are in the country without legal permission,” Beam reports.
The article points out that even though California’s Medicaid now covers around 15 million people, “the rates it pays doctors have not kept up.”
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Since 2005, California has taxed managed care organizations — the private companies that contract with the state to provide Medicaid benefits, according to Beam.
“Last year Newsom signed a law that greatly increased this tax. It means the state will get $19.4 billion through 2026. On Thursday, the legislature voted to increase it again, which will generate an estimated $1.5 billion more,” Beam writes.
It has not been decided yet where the additional money will be allocated, but there is a proposal from Governor Newsom in which optometrists would benefit.
The article adds, “For optometrists, Newsom is proposing to raise rates to match those paid by Medicare,” which “could mean California’s roughly 8,000 licensed optometrists would get a lot more money for Medicaid patients: roughly $130 per exam instead of $47.”
