Atlanta Journal-Constitution Examines Ga. Proposal To Increase Medicaid, PeachCare Reimbursements

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Pregnancy / Obstetrics
Article Date: 14 Feb 2008 - 6:00 PDT

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The Atlanta Journal-Constitution on Tuesday examined a fiscal year 2009 budget proposal from Gov. Sonny Perdue (R) that would increase reimbursements for physicians and hospitals treating beneficiaries of Medicaid and PeachCare -- the state's version of SCHIP -- including those that perform obstetric care.

According to the Georgia Department of Community Health, 1.4 million people in the state are enrolled in Medicaid or PeachCare, and 57% of all births in the state are covered by the program. Medicaid and PeachCare reimbursement rates have been below the actual costs of providing services "for years," the Journal-Constitution reports. The last time state physicians were given a general reimbursement increase from Medicaid was in FY 2003, according to budget documents. The Access Healthcare Coalition -- which includes physician, hospital and business groups -- said Georgia ranks 39th in the U.S. in Medicaid spending per beneficiary, which is about $800 less per beneficiary than the national average.

Thaddeus Chapman, an Atlanta-based ob-gyn, said he has received the same rate of about $1,300 in reimbursements per obstetric case from Medicaid for several years. "We can't even break even," Chapman said, adding, "About $2,200 is (breaking) even. We need to make a profit, too." Chapman said if he is forced out of business due to low reimbursement rates, his patients will have a harder time finding an ob-gyn who will treat them.

Under Perdue's budget proposal, physicians, hospitals, home health agencies and nursing homes would receive a rate increase. The increase would cost $55 million in state funds, and with federal matching funds, would total $154.8 million, the Journal-Constitution reports. The proposal includes a 2.5% -- or about $32 -- increase in Medicaid reimbursement for each infant delivery (Miller, Atlanta Journal-Constitution, 2/12).

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