This is a big problem in California, it is very difficult already to find physicians who will take Medicaid, thus the pay decrease will limit access even more and possibly the same with hospitals.  With finally having a budget, healthcare facilities are now just starting to get checks as they were on hold since July 1st until the budget was done in California. 

How tight are things in California?  Tight enough to where our governor is asking for a 7 billion dollar loan .  Prisons here are not supplying adequate healthcare as well with a federal judge becoming involved in the situation.  BD 

Twenty-six states and the District of Columbia budgeted for higher Medicaid physician rates for fiscal year 2009, which began on July 1 in many states. This is the fourth year in a row that most states have raised pay across the board or at least for some specialties, according to an annual survey of state Medicaid directors released Sept. 29. Six states adopted increases larger than 5%, said Eileen Ellis, one of the report's co-authors and a principal with Health Management Associates, a research firm.

Some states already have resorted to physician pay reductions or are strongly considering doing so as they try to balance their Medicaid books.

California lawmakers, facing a $15 billion budget deficit earlier this year, cut physician pay -- among other Medicaid expenditures -- by 10% across the board effective July 1. But a recent court decision has put this on hold for now.

AMNews: Oct. 20, 2008. Trend of Medicaid pay increases is expected to end as states struggle ... American Medical News

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