Calif. Medical Groups File Lawsuit Challenging Medi-Cal Payment Cuts
On Monday, a number of professional medical associations filed a lawsuit against HHS and the state Department of Health Care Services over the recent approval of a 10% cut in Medi-Cal reimbursement rates, the AP/Sacramento Bee reports. Medi-Cal is California's Medicaid program (AP/Sacramento Bee, 11/21).
The California Medical Association, the California Dental Association, the California Pharmacists Association, the National Association of Chain Drug Stores and the National Community Pharmacists Association filed the lawsuit (CMA release, 11/21).
In October, CMS approved the state's plan to reduce certain Medi-Cal payments by 10%. State officials have projected that the cuts will save $623 million.
According to DHCS, CMS has allowed the state to make a 10% reimbursementÂ cut to:
- A number of providers and outpatient services, including clinics, dentists, laboratories, optometrists and pharmacists; and
- Freestanding nursing and adult subacute care facilities, as well asÂ other nursing facilities.
The cuts are retroactive to June 1.
Heath care providers and patient advocates have argued that the cuts would cause more health care providers to stop treating Medi-Cal beneficiaries.
They also have said that the Obama administrationÂ could beÂ jeopardizing the federal health reform law because the Medi-Cal system will be ill prepared to handle the large number of low-income patients who will become newly eligible for coverage (California Healthline, 11/3).
According to the lawsuit, the 10% cut to reimbursement rates did not go through the appropriate legal procedures (AP/Sacramento Bee, 11/21).
Francisco Silva, CMA general counsel and vice president, said that in September, CMS asked DHCS for more data to substantiate the state's plan to enact Medi-Cal payment cuts. Silva said, "Without receiving that information, CMS went ahead and approved the cuts," adding, "It is clear that CMS did not follow protocol and applied the wrong legal standard" (CMA release,Â 11/21).
The medical professionals also argue that the cuts will further harm the Medi-Cal system and that beneficiaries already find it challenging to find physicians who participate in Medi-Cal (AP/Sacramento Bee, 11/21).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.