Patients File Suit Against Madera Community Hospital Over Decision to Drop Medi-Cal Contract
Three Madera women yesterday filed a lawsuit against Madera Community Hospital over the facility's decision last November not to renew a contract with Medi-Cal, alleging that the move has led to "illegal policies," the Fresno Bee reports (Leedy, Fresno Bee, 5/3). Last November, Madera Community dropped the Medi-Cal contract after hospital representatives could not reach an agreement with state officials on reimbursement rates. The hospital had sought a 25% increase in reimbursement rates (California Healthline, 12/7/01). The lawsuit, filed in Madera County Superior Court, accuses the hospital of "treating Medi-Cal beneficiaries differently than other patients," a violation of the state's Hill-Burton Act, which requires hospitals that receive federal funds during construction to contract with Medi-Cal. The lawsuit, which seeks unspecified monetary damages, also alleges that the hospital has violated other laws by "telling Medi-Cal patients they must be transferred" to other facilities for elective surgeries. The plaintiffs, represented by California Rural Legal Assistance Inc., said that the hospital has an "obligation to provide certain services whether or not they turn a profit." Madera Community CEO Robert Kelley said that the hospital provides emergency care for Medi-Cal beneficiaries and that Medi-Cal reimburses the hospital on a per-case basis for emergency care. "We are still a Medi-Cal approved hospital; the state just dictates how we're paid," he said, adding, "I don't think there is anything to (the lawsuit)" (Fresno Bee, 5/3). Last December, the plaintiffs in the lawsuit filed a similar complaint with the federal Office for Civil Rights in San Francisco. The regional OCR will study the complaint and decide whether to investigate the hospital (California Healthline, 12/7/01).
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