Sutter Health Physician Issues Public Comment on Centers for Medicare & Medicaid Services Proposed Rule

WASHINGTON, Feb. 10 -- Martin J. Garcia, internal medicine hospitalist physician at Sutter Health, Oakland, California, has issued a public comment on the Centers for Medicare and Medicaid Services' proposed rule entitled "Medicaid Program: Medicaid Fiscal Accountability Regulation". The comment was written on Feb. 1, 2020, and posted on Feb. 6, 2020:

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As a Internal Medicine Hospitalist physician practicing at a large Sutter Health hospital in Oakland, CA, I am writing to urge the Centers for Medicare & Medicaid Services (CMS) to withdraw the "Medicaid Fiscal Accountability Regulation." I am concerned that the proposed rule would significantly reduce state and federal Medicaid funding which would negatively impact my practice and access to care for Medi-Cal patients in my community.

This proposed rule would have significant adverse impact on the population that my hospital serves. As it is there already a general deficiency of primary care physicians in our community. With further loss of Medi-Cal participants and eligibility, people will receive even less health care and result in a larger volume of untreated, sick people, seeking much more costly care at local hospital emergency rooms and hospitals like ours. This impact will also be felt by patients who have insurance via Medicare, private or employee sponsored health insurance. This adverse impact on local hospitals is already felt greatly from the current level of uninsured patients. As a large urban, not-for profit medical center, we accept transfers and provide care to uninsured patients from throughout northern California. As it stands, our hospital is always functioning near maximum capacity and can barely service the needs of our local community. This new rule will only result in compounding the problem of more, sicker, ED patients and full hospitals.

The proposed Medicaid cuts would reduce or eliminate medical services for 13 million Californians, some of whom are our most vulnerable patients - children, the elderly, and disabled. Nearly half of all California's children and disabled are enrolled in Medi-Cal. Physicians, dentists, hospitals and other providers in my community will be impaired in our ability to continue to participate in the Medicaid program, exacerbating existing provider shortages and patient access to care challenges.

The rule will disproportionately harm California's rural and underserved areas where 2/3 of the residents are enrolled in Medi-Cal and there are already serious provider shortages, hospital closures, and patients travelling long distances to receive care. When patients are forced to delay care, their conditions worsen and ultimately become more challenging and costly to treat.

On behalf of my patients, I urge CMS to withdraw the rule.

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The proposed rule can be viewed at: https://www.regulations.gov/document?D=CMS-2019-0169-0001

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