No pay hike, but specialists seem OK with Medicaid

By David McGrath Schwartz (contact), Cy Ryan (contact)

Wednesday, Aug. 13, 2008 | 2 a.m.

More obstetrician/gynecologists and fewer general surgeons are seeing patients enrolled in the state’s Medicaid program.

A survey by the state Health Care Financing and Policy Division found an overall increase in specialists seeing patients in the program for low-income Nevadans, despite the effect of state budget cuts on their reimbursement rates.

Because of the cuts there will be no increase in physician rates, and some doctors will see reductions in reimbursements. The Legislature had set aside $17 million to boost payouts beginning this month, but that increase was lost to cuts.

Division Director Charles Duarte had expected fewer physicians to participate in the program.

The survey showed that 96.3 percent of the state’s obstetrician/gynecologists have signed up to serve Medicaid recipients this year, compared with 71 percent in 2006. Psychiatrists contracting with Medicaid jumped to 88 percent this year, from 58 percent in 2006. Dermatologists, gastroenterologists and neurologists in the program all increased by 20 percent.

The declines were among general practice physicians (from 71 percent to 68 percent), general surgeons (from 77 percent to 58 percent) and internists (from 94 percent to 79 percent), as well as other specialists.

The biggest problem, according to Duarte, is urology surgeons. The survey showed none is signed up with Medicaid.

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Assembly Speaker Barbara Buckley was a heartbeat — or a road trip — away from the governor’s job last week.

State Sen. Mark Amodei had been “acting with gubernatorial authority” Wednesday through Friday because Gov. Jim Gibbons and Lt. Gov. Brian Krolicki were out of state.

Gibbons was in Idaho on a trail ride with Gov. Butch Otter and Bureau of Land Management officials to discuss land and conservation issues, according to Ben Kieckhefer, the governor’s spokesman.

He returned to the state Friday.

Krolicki was in Boston seeing family.

Under the state constitution, if the governor is out of state, gubernatorial authority falls to the lieutenant governor. If the lieutenant governor is out of state, it falls to the president pro tem of the state Senate, who is Amodei, R-Carson City. If the president pro tem is out of state, the job falls to the speaker of the Assembly, who is Buckley, D-Las Vegas.

This isn’t the first time Amodei has been left in charge. In June 2007 both Gibbons and Krolicki toured the aftermath of the Angora fire in California.

Amodei didn’t return calls for comment Friday afternoon. But Kieckhefer said he did not believe Amodei had performed any gubernatorial acts.

•••

The mother of a murder victim is voicing concerns over the pending parole of the inmate who was once sentenced to death for the crime.

Hama Sylvester has asked Gibbons and the state Parole Commission to reconsider the decision to release James Allen, 48, from the Southern Nevada Correctional Center.

In 1980, Allen, who was then 19 years old, broke into the home of Sylvester’s son, Tony, intending to burglarize the place. Tony Sylvester awoke and walked into the hallway, where Allen fatally shot him in the face.

In a letter to the governor, Sylvester, 76, wrote: “James Allen’s criminal behavior that night has continued to haunt my family all of these years ... Must my family and I spend the rest of our lives looking over our shoulder to make sure James Allen is not stalking us and plotting his revenge?”

Allen was originally sentenced to death, but the Nevada Supreme Court overturned the penalty. During a subsequent state Pardons Board hearing Allen told the board he was sorry for the killing and God had punished him every day for the crime.

At its meeting in June, the Parole Commission voted to release Allen, who has a good disciplinary record in prison.

David Smith, executive director of the parole board, said Sylvester’s appeal has been circulated to board members, who will decide whether to reconsider their decision.