Appeals Court Rules That Calif.’s 2009 Medi-Cal Cuts Were Illegal
Last week, the 9th U.S. Circuit Court of Appeals ruled that cuts made by state officials in 2009 to Medi-Cal services for individuals in rural and other underserved areas were illegal, the Sacramento Bee reports.
Medi-Cal is California's Medicaid program (Walsh, Sacramento Bee, 7/6).
In 2009, the state Legislature attempted to reduce state spending by eliminating coverage for certain Medi-Cal benefits, including:
- Adult dental care;
- Chiropractic treatment; and
- Podiatry services.
The California Association of Rural Health Clinics and a community health center in Kings County sued the Department of Health Care Services and state officials over the cuts, alleging that the Medi-Cal changes conflict with federal law. A court order reinstated the coverage in October 2010.
The state resumed payments for such services until May 2011, when it received CMS approval to eliminate coverage of benefits considered optional under Medi-Cal. DHCS then determined it had the authority to recoup payments that were made during the court-mandated period (California Healthline, 10/19/11).
Details of Recent Ruling
In Friday's ruling, the three-judge panel wrote that the cuts "impermissibly eliminate[d] mandatory services from coverage" (Sacramento Bee, 7/6).
Judge Dorothy Nelson wrote that federal law "unambiguously defines" such benefits as mandatory under Medicaid.
State Response, Options
Norman Williams, a spokesperson for DHCS, said the ruling only applies to Medi-Cal beneficiaries receiving care at federally funded health centers (Levine, Reuters, 7/5).
Matt Robinson, a DHCS spokesperson, in an email said the agency "is examining this ruling and considering its potential next steps."
According to the Bee, the state's options include:
- Seeking reconsideration by the appeals court;
- Requesting a hearing before a larger appeals panel within the 9th Circuit;
- Seeking a review by the U.S. Supreme Court; or
- Complying with the ruling (Sacramento Bee, 7/6).