Appeals court: Calif. can cut Medicaid reimbursement rates

A federal appeals court panel ruled Thursday that Medi-Cal payments to providers may be reduced by 10 percent -- a move that HHS had previously approved.

Los Angeles Times: Court Ruling Could Cut California Spending On Medi-Cal
In a potential windfall for the state, a federal appeals court decided unanimously Thursday that California may cut reimbursements to doctors, pharmacies and others who serve the poor under Medi-Cal. A three-judge panel of the 9th Circuit U.S. Court of Appeals overturned injunctions blocking the state from implementing a 2011 law that slashed Medi-Cal reimbursements by 10 percent. Medi-Cal, a version of Medicaid, serves low-income Californians (Dolan and Megerian, 12/13).

Los Angeles Times: California Medical Group Warns Against Medi-Cal Reimbursement Cuts
Despite a federal appeals court ruling Thursday allowing California to cut Medi-Cal reimbursement payments, a spokeswoman for the California Medical Assn. said the group hoped the state would decide against doing so. Earlier this year, U.S. District Court Judge Christina Snyder granted injunctions blocking a 10 percent cut to Medi-Cal reimbursement rates to health care providers. State officials had said the court's injunctions were costing the state more than $50 million a month (Dolan, 12/13).

San Francisco Chronicle: Medi-Cal Cuts Upheld By Appellate Court
[The court] said it was required to defer to the U.S. Department of Health and Human Services, which decided in October 2011 that lowering the Medi-Cal rates was unlikely to reduce access to health care. The federal government, which provides at least half the cost of Medi-Cal services, must approve all rate cuts. The appeals court noted that federal department also reached its conclusion without studying the costs of providing care. Considering such costs before reducing providers' rates "seems at first blush to be logical," ... But "the executive branch has been giving careful consideration to the ins and outs of the program since its inception, and the (federal) agency is the expert," said Judge Stephen Trott in the 3-0 ruling (Egelko, 12/13).

Reuters: California May Cut State Medicaid Reimbursement Rates: Court
Attorney Lynn Carman, who represents the Medicaid Defense Fund, said the court's decision was "totally without merit." A spokesman for Brown welcomed the ruling. "Today's decision allows California to continue providing quality care for people on Medi-Cal while saving the state millions of dollars in unnecessary costs," spokesman Gareth Lacy said in a statement. Carman said his non-profit group would ask for a review of the decision by the full 9th Circuit. If a review is denied, he said he expects to file an appeal to the U.S. Supreme Court (Christie, 12/13).