SMART Act (Illinois)

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SMART (Save Medicaid access and resources together) act is a senate bill passed on May 24, 2012 to save 2.7 billion dollars. Savings will be generated by reducing physician reimbursement rates and patient access to a number for services. For example, hospitals are receiving a reduction in reimbursement rate (3.5% decrease), certain services are being scaled back (such as podiatry), and certain services are being discontinued (such at chiropractic care). Under this new bill, Medicaid patients will have access to podiatric care ONLY if they are diabetic. This is not a massive catastrophe because podiatrists are not financially compensated very well for their services on Medicaid, I know several pods who rarely (if ever) see Medicaid patients because the reimbursement rates are so low.

This is somewhat alarming because many other insurance providers mirror the Medicaid mold. Do you see where I am going with this?... I'd like to hear some input.

Originally Posted by JonScholl

SMART (Save Medicaid access and resources together) act is a senate bill passed on May 24, 2012 to save 2.7 billion dollars. Savings will be generated by reducing physician reimbursement rates and patient access to a number for services. For example, hospitals are receiving a reduction in reimbursement rate (3.5% decrease), certain services are being scaled back (such as podiatry), and certain services are being discontinued (such at chiropractic care). Under this new bill, Medicaid patients will have access to podiatric care ONLY if they are diabetic. This is not a massive catastrophe because podiatrists are not financially compensated very well for their services on Medicaid, I know several pods who rarely (if ever) see Medicaid patients because the reimbursement rates are so low.

This is somewhat alarming because many other insurance providers mirror the Medicaid mold. Do you see where I am going with this?... I'd like to hear some input.

My thought would be that pods leave Illinois altogether and then all the demand for footcare will fall onto untrained and un-wanting docs, and Illinois will realize how important pods are to the healthcare team, so they'll quit bullying them around and respect their services just like any other medical speciality.

Most insurances mirror MediCARE, so Medicaid cutting off podiatry isn't a big deal I suppose. When the Medicare plan changes and reflects the Medicaid changes, it's time to press the panic button.

As a side note, I wonder where these people are going to get foot/ankle care. Mostly from PCPs and ERs I guess, which will work for the basics. Good luck though if you have anything more than PF. At the end of the day, I don't know how it's going to save money. They're going to get F/A care from somewhere, and probably from a less efficient and knowledgeable source.

Originally Posted by Podophile

When the Medicare plan changes and reflects the Medicaid changes, it's time to press the panic button.

What's to say this won't be happening soon as well?

Originally Posted by Podophile

Most insurances mirror MediCARE, so Medicaid cutting off podiatry isn't a big deal I suppose. When the Medicare plan changes and reflects the Medicaid changes, it's time to press the panic button.

We, as a profession, should take action prior to that. If we only start fighting back when it's time to panic then we've already lost. Being proactive is a necessity.

The more I think about this, the more confused I am. Isn't Scholl the oldest school of podiatry? You'd think Illinois would have a strong history of podiatrists and the lobbying in the state would be perfected...

This, along with New York's scope (which I understand better, being NYC and all), never makes sense to me.

DMU's past president is the governor of Iowa, California made some noise a few months ago by working with california's medical association to give pods full scope (anyone hear anything recent from that?).

I would just assume the states where the schools are (and are pod-saturated) would have the more progressive laws.... Hmm

Originally Posted by MaxillofacialMN

The more I think about this, the more confused I am. Isn't Scholl the oldest school of podiatry? You'd think Illinois would have a strong history of podiatrists and the lobbying in the state would be perfected...

This, along with New York's scope (which I understand better, being NYC and all), never makes sense to me.

DMU's past president is the governor of Iowa, California made some noise a few months ago by working with california's medical association to give pods full scope (anyone hear anything recent from that?).

I would just assume the states where the schools are (and are pod-saturated) would have the more progressive laws.... Hmm

NYCPM is the oldest school.

Originally Posted by dyk343

NYCPM is the oldest school.

Duly noted.

I'll take historical podiatry schools for 500, Alex.

Originally Posted by MaxillofacialMN

Duly noted.

I'll take historical podiatry schools for 500, Alex.

haha
NYCPM, Scholl, and CSPM are all around the same age. (not that it matters)

Originally Posted by dyk343

haha
NYCPM, Scholl, and CSPM are all around the same age. (not that it matters)

Ah! Thanks. I just figured if you had a pod school in your state and then the inevitable saturation because of the state your state would be more disposed to pods and understand what they do/are capable of.

Poor example but I'll use it: I live in MN, and there are chiropractors everywhere, but in my hometown there is only one pod office (3 docs, but still). So growing up, I drove past a chiropractor like everyday and I therefore knew what they were by just being commonplace. The one pod clinic in my hometown (I found out after coming back from a break at college) is in a medical building so they don't have a shingle out front (a guess a little sign on the big one). So if I were a legislator and I didn't go to school in the sciences and find out about pods, I might be more skeptical of them and their training, whereas in Iowa (I go to school there) there are old clinics EVERYWHERE in my town, and when I mention who I'm shadowing to people, people know who I'm talking about, so the average awareness is higher I think in states with schools, I'd imagine it'd be more heightened if the school has been around longer as parents would have gone to a pod, then the kids, then grand kids etc, just a part of life.

Sorry this is a super long discussion on something I just found interesting about scope and things like this issue in Illinois.