Restore Medi-Cal benefits eliminated a decade ago


Services especially for people suffering from diabetes, among whom they are covered again

LOS ANGELES.- The doctor John chisholm, podiatrist of San Diego, remember the impact that some of your patients suffered in 2009 when Medi-Cal, the California Medicaid for people of low income, eliminated that coverage and other benefits for adults due to the huge budget deficit generated by the Great recession.

For some of their patients, the consequences were catastrophic. Many of them had diabetes and could no longer afford foot care, vital for people with that disease that can constrict blood flow and cause serious damage. The patients simply stopped keeping their appointments.

He only saw them again when they called him from an emergency room to perform amputations to those whose disease had not been controlled.

“For many poor workers, losing this coverage was devastating“Said Chisholm. “People had to choose between the basic necessities of life or go to the doctor. I saw a lot of pain. ”

This month, Medi-Cal restored podiatry Y other health benefits for Adults eliminated more than a decade ago, including lenses and speech therapy, as well as ear exams, hearing devices and other services. The state budget for the 2019-2020 period provides $ 17.4 million to pay for this coverage.

Some 13 million Californiansincluding 7 million adults, are covered by Medi-Cal.

“Millions of people now have access to medical care that they didn’t have before,” he explained. Anthony Wright, executive director of Health Access California, a consumer advocacy group based in Sacrament. “And we have found that services such as podiatry, audiology and speech therapy are clearly necessary from a medical point of view.”


Anthony Cava, a spokesman for the California Department of Health Services, said the recently restored benefits are only the latest in a gradual restoration of care for the state’s low-income adult population. Acupuncture returned in 2016, Y dental benefits in 2018Cava added.

Raquel Serrano, 67-year-old farm worker from ash tree, will be one of the people who will take advantage of the restored benefits of Medi-Cal. Serrano learned that he had diabetes a decade ago, but recently enrolled in Medi-Cal. For years he drank sugary soda with every meal and hot chocolate with bread at bedtime.

“My parents had no diabetes education,” said Serrano’s son, José, the oldest of six children. “The soda was something we had on the table for breakfast, lunch and dinner. We drank sodas, not water. ” Now his mother can see a chiropodist, get glasses and fix the teeth. “We think this will add years to your life,” Serrano said.

Most patients with diabetes require oral health services.


Those who support the restoration of benefits ensure that take care of the feet of people with diabetes, like Serrano, it will be a great saving for the state. An analysis conducted in 2017 by researchers from the UCLA estimated that the use of preventive podiatry services saved Medi-Cal up to $ 97 million in 2014, which can be attributed to the avoidance of hospital admissions and amputations.

Lower limb amputations rose across California in an amazing 31% between 2010 and 2016, according to data from state hospitals reported by Inewsource, a nonprofit investigative journalism organization based in San Diego.

Chisholm attributes the increase, in part, to the elimination of podiatric benefits for Medi-Cal patients. “We cannot say with certainty,” he said, “but California suffered an avalanche of amputations after these cuts. They are convincing figures. ”

Chisholm, who runs podiatry offices in National City and Chula Vista, two working-class neighborhoods in San Diego, said that an older Latino person he had treated for years couldn’t pay him when Medi-Cal stopped covering his treatments in 2009, so he offered to treat him for free.

But for some reason, be it shame or some bureaucratic confusion, the woman stopped going to the office, the doctor said. Chisholm did not hear from her again until one day he was called from an emergency room to perform an amputation below the knee. She was the patient.

Although the benefits have now been restored, many activists wonder if patients who need to see podiatrists, audiologists or speech therapists can get appointments.

“Many of these providers have not worked with Medi-Cal for years, so it could be a challenge to accommodate all these patients,” said Nadereh Pourat, associate director of the UCLA Health Policy Research Center.


Chisholm said that California has recently reduced the amount of paperwork required by health care providers to receive their reimbursements for the services they offer to Medi-Cal patients.

“It used to be a bureaucratic nightmare, including paperwork and documentation, getting the government to reimburse you for even the simplest procedures,” he explained. “But that it has improved, same as refund rates“.

Many doctors in California have refused for years to treat patients enrolled in Medi-Cal due to low program payment rates, but the state has increased those rates, in some cases substantially, in the last two years.

But the latest restoration of the benefits of Medi-Cal is so new that many doctors and patients still do not fully understand it.

And Spanish speakers face an additional complication, according to J. Luis Bautista, who runs two clinics in the Central Valley that primarily care for Latino patients, many of whom are in Medi-Cal.

“What patients hear on the news and read on the Internet is different. They are not sure which services are covered and which are not, ”said Bautista.



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