Plaintiffs Request Review of 10% Medi-Cal Cut

Sacramento Business Journal by Kathy Robertson –

January 28, 2013:

Plaintiffs in a lawsuit to stop a 10 percent cut in Medi-Cal provider rates filed court documents Monday asking for review of the case by a full panel of appeals court judges.

In December, a three-judge panel reversed a lower court decision that blocked California’s attempt to cut Medi-Cal fees — essentially affirming the state’s right to make authorized cuts to the federal health care program for the poor.

Plaintiffs contend a cut in state Medi-Cal provider fees, already below the cost of providing care and among the lowest in the nation, will do “irreparable harm” to access to care for the state’s most vulnerable patients.

Heavyweights among the plaintiffs include the California Medical Association, California Hospital Association, California Dental Association and California Pharmacists Association, as well as trade groups representing medical product suppliers and other interests.

The cuts were part of a budget fix proposed in 2011, but the state is in better financial shape now, plaintiffs contend. The cuts also come at a time when the state is planning to move millions more patients in to Medi-Cal under federal health reform.

“The cuts will threaten implementation and further hamper already difficult access to care,” CMA president Dr. Paul Phinney said in a call with reporters.

The cuts will hit skilled nursing units in hospitals especially hard, said Duane Dauner, president and CEO of the California Hospital Association. The 10 percent cut for these units will be made on rates for fiscal year 2008-2009, translating to a 25 percent cut.

The lower court decision will remain in place until an “en banc” decision is made by the full Ninth Circuit Court of Appeals.

Source: John & Rusty Report via Choice Admin