Organizations, Hospital Associations Seek To Block 10% Medi-Cal Cut
Several organizations have filed amicus briefs in opposition to a 10% Medi-Cal reimbursement cut, Modern Physician reports. Medi-Cal is California's Medicaid program (Robeznieks, Modern Physician, 2/13).
Background on 10% Cut
In October 2011, CMS approved the California's plan to reduce certain Medi-Cal payments by 10%. The state Department of Health Care Services has estimated that the cut will save the state $431 million.
According to DHCS, the cut would apply 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.
Payment reductions would be retroactive to June 1, 2011.
In January 2012, U.S. District Court Judge Christina Snyder tentatively blocked the cut, saying it could cause irreparable harm to patients.
In December 2012, a three-judge panel of the 9th Circuit Court of Appeals overturned the decision, ruling that HHS Secretary Kathleen Sebelius has authority to decide whether California and other states can reduce Medicaid rates while still adhering to program regulations.
Health care providers last month appealed the decision, requesting that the entire 9th Circuit review the case (California Healthline, 1/29).
Details of Amicus Briefs
Last week, several not-for-profit organizations across the U.S. filed an amicus briefÂ opposing the cut. The organizations included:
- The California Advocates for Nursing Home Reform; and
- Disability Rights California.
According to the brief, the cut could reduce access to care because health care providers might leave Medi-Cal if their costs are higher than the program's reimbursements.
The brief states, "Rather than analyze up-front the impact of an across-the-board reimbursement cut, California instead proposed that it would monitor for access problems later."
It adds, "That ostrich-like approach ignores repeated decisions from this Court recognizing that Medi-Cal rate cuts force health care providers to limit the number of new Medi-Cal patients they accept or stop treating them entirely."
The American Hospital Association and eight state hospital associations last weekÂ filed a separate amicus briefÂ opposing the cut. The hospital associations represented:
- Oregon; and