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tospecialistsforfurtherdiagnosesand
treatment.Thepaymentswereceive
for
services
provided
to
Medi-Calpatients
arewellbelowour
cost
structure.
8.
Theratespaidforphysician
services
havebeen
inadequate
formany
years.
I
haveneverthelessprovided
services
to,
andcurrentlycontinue
to
serve,
Medi-Calpatients
because
of
their
medicalneeds
and
the
lack
of
access
to
medical
services
experiencedby
suchpatients,
I
am
personallyaware
of
the
lack
of
access
for
Medi-Cal
patientstospecialists
andevengeneralists,
having
beenunsuccessful
onmany
occasions
inreferringa
Medi-Cal
patientto
suchprovidersforfurther
prenatal
care,
diagnosisand/ortrea
tment.
9.
IunderstandthattheCalifornia
Department
of
Health
Care
Services
is
planningtoimplementatenpercent
(10%)
ratereductionon
adult(ove
r
21
years
of
age)
physicians’services,
which
has
been
approvedby
the
federalgovernment.This
rate
cutdirectlyaffects
the
ability
of
physicians,such
as
myself,
to
continue
toprovide
servicesto
adultMedi-Cal
patients.
I
also
understandthat
the
rate
cutwillbe
implementedretroactivelyto
June
1,2011.
The
rate
cutwillreduce
the
amount
the
State
will
payaphysicianfor
all
types
of
services
provided
toadults,and
willsignificantlyreducethereimbursement
amount
payable
forsuch
services.
10.
If
thistenpercent
(10%)
rate
reduction
is
implemented,
I
will
significantlyreducethenumber
of
Medi-Cal
patients
1
see.
At
this
time,Medi-Cal
rates
are
so
low
that
they
do
noteven
cover
the
cost
of
the
patient’s
visit.
As
a
result,
otherpatientsare
in
effect
subsidizing
the
services
provided
tomy
Medi-Cal
patients.
This
is
unfair
to
otherpatientsand
cannot
be
allowed
to
continue.The
servicesthatotherphysicians
and
I
offer
should
be
recognized
for
the
valuewe
providetoC
aliforniacommunities,
the
patients
weserve,
and
the
state
as
a
whole.
However,
the
unfortunate
result
of
this
decision
is
that
many
of
my
patients
will
havetofind
a
new
physician,rely
onemergencyroomservices
or
foregohealthcare
services
for
their
pregnancies
entirely.
1
2
3
4
5
6
7
S
9
10
11
a8
1213
14
c18
15
-,
us
16
eI
0.
ws
k.
s
oI-z—
z
-I
us
19
20
21
22
23
24
25
2627
28
2042209]
2
DECLARATION
OF
BRUCEKOVACS.
Ml)
IN
SUPPORT
OF
PLAIN1TFFS’
MOTIONFOR
PRELIMINARY
INJTJNC11ON
Case 2:11-cv-09688-CAS-MAN Document 52 Filed 12/30/11 Page 3 of 5 Page ID #:283