California ED Physicians Sue State Over Inadequate Payments

On Tuesday, a coalition of emergency department physicians filed a lawsuit against the California Department of Health Care Services, alleging that inadequate Medi-Cal reimbursements are compromising the state's ED system, the Los Angeles Times reports.

Medi-Cal is California's Medicaid program (Yoshino, Los Angeles Times, 1/28).

The suit seeks class-action status and calls for:

• Restitution;
• Unspecified damages; and
• An order declaring that ED physicians have a right to be "justly compensated."

The suit maintains that ED physicians provided $100 million in unpaid services in 2007 (Mohajer, AP/Ventura County Star, 1/28).

The plaintiffs also argue that the cost of providing emergency care has nearly doubled over the past decade, while the number of patients seeking care in EDs has jumped by more than 28%.

The physicians maintain that Medi-Cal reimbursements have remained relatively constant over the same period, and a 1% cut in Medi-Cal reimbursement rates for ED physicians is scheduled to take effect on March 1 (Goldeen, Stockton Record, 1/28).

Plaintiffs

Plaintiffs named in the suit are:

• Centinela Freeman Emergency Medical Associates;
• Sutter Emergency Medical Associates;
• Valley Emergency Medical Associates;
• Valley Emergency Physicians Medical Group; and
• Valley Presbyterian Emergency Medical Associates (AP/Ventura County Star, 1/28).

The suit was filed in Los Angeles County Superior Court (Stockton Record, 1/28).

State Response

State DHCS spokesperson Anthony Cava said officials are reviewing the complaint and cannot comment on specific arguments in the suit.

In a written statement, Cava said Gov. Arnold Schwarzenegger's (R) administration has "long maintained the need for comprehensive health care reform in California to improve the health care delivery system in ways that would benefit patients and those who are on the front lines in delivering health care, including emergency room physicians" (Los Angeles Times, 1/28).