February 7, 2016
Yes. Medi-Cal would have to offer spinal manipulative therapy as an alternative to addicting patients to opiates or forcing them into spinal surgery if a patient wants treatment for spinal related pain. Medi-Cal would have to pay for treatment by acupuncturists that is competently rendered and focused on successfully treating the condition for which treatment is sought.
For doctors who are employees of Medi-Cal, Medical could mandate that doctors provide a therapeutic trial before ordering “confirmatory tests”. If the trial is effective, the diagnosis is confirmed. The test would have been unnecessary. Medi-Cal could not refuse a patient’s request for a test, but Medi-Cal could refuse to keep employee staff that wastes money. However, before firing a provider for not following the employer’s treatment policy the employer would have to prove that the doctor was a) not responding to patient requests when providing care contrary to policy, b) was negligent or incompetent, c) wasting money, d) the policy was the best treatment for the patient, e) the provider failed to attempt to educate and inform the patient concerning the benefits and risks of the policy.
In fact the same model could be used by HMO’s, saving bundles of money.
Medical could control costs by limiting the conditions it treats.