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San Francisco Marin Medical Society Blog

Judge Likely to Block Medi-Cal Cuts



A federal judge has issued a tentative decision blocking California from cutting reimbursements to health care providers who treat low-income patients by 10 percent. SFMS/CMA, California Dental Association (CDA), California Pharmacists Association (CPhA), National Association of Chain Drug Stores, National Community Pharmacists Association, AIDS Healthcare Foundation, American Medical Response and the California Association of Medical Product Suppliers filed the lawsuit against the U.S. Department of Health and Human Services and the California Department of Health Care Services in November 2011. The organizations believed that if the cuts went through, access to care for Medi-Cal patients would be eroded or cut off completely. "The court's tentative ruling is encouraging to those of us practicing medicine," said Dr. James T. Hay, the president of the California Medical Association in a statement. "The state's repeated attempts to slash Medi-Cal reimbursement rates is a short-sighted solution that balances the budget on the backs of the poorest and the most vulnerable Californians." In March of 2011, Governor Jerry Brown signed AB 97, which cut the reimbursement rate for physicians, hospitals, dentists, pharmacists and other Medi-Cal providers by 10 percent. The bill was part of the state's strategy to reduct its budget deficit. In November, the California Medical Association went to court to block the cuts. Because California’s Medi-Cal rates are already extremely low and many prescription medications are reimbursed at breakeven rates, many providers cannot afford to participate. Kaiser State Health Facts lists California as the lowest reimbursed state in the nation. U.S. District Court Judge Christina Snyder issued a 25-page tentative order, wherein she favored the plaintiffs’ request for a preliminary injunction. A final order, if consistent with her tentative ruling, will enjoin the cuts and is expected in the near future.


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