State to cut Medicaid payments to doctors; local hospitals exempt

June 6, 2011 

Payments to South Carolina's doctors for treating Medicaid patients will be reduced by up to 7 percent as the state cuts about $125 million from the program, officials announced Monday.

Medicaid patients -- generally poor and disabled -- also will pay more for some visits. On July 1 their co-payments will go from $2.30 to $3.30, the maximum allowed by federal law, for doctor, clinic, home health and optometrist visits.

Reimbursement rates to doctors, dentists and most hospitals will be cut July 8 for a second time this year. In April, rates were reduced 3 percent.

The reductions will not affect Hilton Head Hospital, Beaufort Memorial Hospital or Coastal Carolina Hospital in Hardeeville, which are among 24 hospitals exempted from the cuts.

Because they serve proportionally more Medicaid patients, reducing their reimbursement rates would be a greater hardship for them, state officials said. For the other hospitals, the reimbursement-rate reduction will be 4 percent.

Reimbursements rates are being cut because "the state must continue to drive excess cost out of the entire system if we are to truly have any chance of making health care more affordable to more people and to prevent health care costs from overwhelming our state budget," said Tony Keck, the state's health and human services director.

Associations representing doctors and hospitals, however, have said the cuts will harm patients when doctors stop accepting Medicaid altogether.

"There are physicians that could be severely harmed by these additional cuts, which means that their patients may have added difficulty finding adequate care," Todd Atwater, CEO of the S.C. Medical Association and a Republican legislator from Lexington, said in a statement.

For doctors, the rate reductions will vary by profession. Most primary care and pediatric specialists will see a 2 percent cut, while dentists and anesthesiologists will be cut 3 percent. Payments will be reduced by 5 percent for oncologists, endocrinologists, gastroenterologists, gynecologists and cardiologists; and by 7 percent for personal care attendants, podiatrists, audiologists, psychologists, chiropractors and some other health professionals.

State Sen. Tom Davis, R-Beaufort, called Medicaid the "crack cocaine" of government budgeting during a speech to a Republican group Monday on Hilton Head Island.

Davis told the First Monday Republican Lunch Group the state will spend $1.1 billion this year compared to $161 million five years ago to cover about the same number of Medicaid patients -- about 950,000. He attributed the increase to lawmakers' desire for matching federal dollars.

"It's a 3-to-1 match from the federal government," Davis said. "That's why we can't lay down the pipe.

"People argue that's going to kick people off the rolls and deprive them of services, but in reality we are taking limited resources and making sure they go to people most in need."

Packet and Gazette staff writer Tom Barton contributed to this report.

The Island Packet is pleased to provide this opportunity to share information, experiences and observations about what's in the news. Some of the comments may be reprinted elsewhere in the site or in the newspaper. We encourage lively, open debate on the issues of the day, and ask that you refrain from profanity, hate speech, personal comments and remarks that are off point. Thank you for taking the time to offer your thoughts.

Commenting FAQs | Terms of Service