S202 – Appropriations Act of 2009 sponsored by Garrou (D-Forsyth) is currently being discussed in subcommittee in an effort to develop a House proposal.  Health and Human Services Appropriations has been meeting daily to discuss the Senate proposal.  NCMS expects further adjustments to either spending or revenue as April reports in revenue come to light over the next week.  It is vitally important that NCMS members contact their legislator to encourage the continued maintenance of 95% of Medicare reimbursement for Medicaid physician services.  With the potential for a $4 Billion dollar shortfall in next years’ budget, physician services will be threatened.  Physician participation remains vital in order for the state to receive a dollar’s worth of service for just a quarter worth of cost to the state.  Physicians will already be held to 95% of the 2007 rate based on the Governor and the Senate’s budget proposals that would eliminate inflation adjustments.  A cut of just 5% to the current rate would send reimbursement back to near 2001 levels.  A recent poll of NCMS members from across specialties showed that a 5% cut would force 39% of NC physicians currently seeing Medicaid patients to limit the number of Medicaid recipients on their patient rolls.  This would force those patients that could not get into a physician’s office to be seen at the Emergency Department.  The limited budgetary gains made by cutting the physician rate would be eclipsed by the increased payments for emergency care.  The CCNC program has proven that a medical home provides the most comprehensive, effective and cost-saving care for Medicaid patients in NC.  In fact, CCNC is being replicated across the country because of these successes.  Please encourage your legislators to maintain this visionary partnership while caring for a needy population of NC citizens.