Lawmakers question proposed cuts in Medicaid reimbursements

Lawmakers Thursday questioned the governor's proposal to reduce the amount Medicare reimburses doctors for services.

Gov. Kenny Guinn proposed cuts for a variety of different medical services designed to save about $5 million in state funding out of the billion dollar Medicaid budget.

Sen. Ray Rawson, R-Las Vegas, said especially with obstetrics, the cuts don't make much sense.

The plan would reduce Medicaid reimbursement for a normal pregnancy and birth from the $1,900 doctors now get to $1,600. Human Resources Director Mike Willden said $1,600 is the Medicaid standard rate for those services.

Rawson pointed out that obstetricians are in short supply -- especially in Southern Nevada -- and some are either leaving the state or threatening to because of medical malpractice insurance costs.

"We have fewer than 100," he said. "If it goes from $1,900 to $1,600, that accentuates the problem," he said.

"A lot of women are e-mailing me that they can't get in to see their regular OB/GYN anymore," Rawson said.

Willden said the cut is just a proposal.

"That decision, the governor has not made," he said. "He is reconsidering it."

But Willden said statistics show Nevada pays physicians more for Medicaid services than almost any other state.

"Physicians are more than likely to see reductions in reimbursements," he said.

The comments came amid criticism from some legislators that the human services budgets including Medicaid should be cut rather than have the state seek tax increases.

Assemblywoman Sheila Leslie, D-Reno, said Nevada's Medicaid budget is minimal.

"Even if we fully fund the governor's budget, we're still going to be 51st in the nation," she said.

John Sasser of Nevada Lawyers for Progressive Policy confirmed that saying Nevada is $50 per person below the next state in Medicaid funding. Medicaid is one of the largest of Nevada's budgets with just under $2 billion in spending planned over the next two years. Of that, $645 million is state general fund money. The majority of the cash is federal.

Medicaid caseloads are expected to increase more than 30 percent over the next fiscal year and 10 percent more in fiscal year 2005 to more than 200,000.