A federal appeals court has reversed a decision earlier this year to suspend a 10% reimbursement cut in Medi-Cal, California's Medicaid program.


Medi-Cal, California's Medicaid program, reimbursement cut, California Pharmacists Association, CPhA, Jon Roth, pharmacists, U.S. Ninth Circuit Court of Appeals, injunction, Judge Christina Snyder, reimbursement reduction for Medi-Cal, California Medical Association et al. v. Douglas, CMA v. Douglas, National Association of Chain Drug Stores, Medi-Cal patients


















































































































































































































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Court lifts injunction halting Medi-Cal reimbursement cut

December 14th, 2012

SACRAMENTO, Calif. – A federal appeals court has reversed a decision earlier this year to suspend a 10% reimbursement cut in Medi-Cal, California's Medicaid program.

The California Pharmacists Association (CPhA) said late Thursday that the U.S. Ninth Circuit Court of Appeals changed a ruling by Judge Christina Snyder in March to uphold an injunction blocking the implementation of a reimbursement reduction for Medi-Cal.

The reversal in the case, California Medical Association et al. v. Douglas, opens the door for the California Department of Health Care Services to move ahead with its plan to scale back Medi-Cal reimbursements.

Besides CPhA, other plaintiffs in the case include the National Association of Chain Drug Stores, California Association of Medical Product Suppliers, AIDS Healthcare Foundation, California Medical Association, California Dental Association and American Medical Response.

"The decision by the Ninth District today is devastating news for Medi-Cal patients who rely on providers for access to life-saving medications as well as medical, dental, medical equipment and specialty healthcare services," CPhA chief executive officer Jon Roth said in a statement.

"If [the reductions are] enacted, Medi-Cal patients will find themselves without a provider because these cuts will drive practitioners out of the system," Roth stated. "At a time when the state is moving ahead with transitioning 900,000 children from Healthy Families into Medi-Cal, and enrolling 5 million to 7 million adults into Medi-Cal under the Affordable Care Act, these cuts are completely contrary to good public health policy."

CPhA said it will continue to work with the coalition of other health care providers to determine their options going forward.

"For a state that continually talks about wanting to be the healthiest in the nation, decisions to enact cuts like these are nothing less than shocking," Roth commented.

In February, Judge Snyder issued a final ruling in CMA v. Douglas case, granting the plaintiffs' request for a preliminary injunction and halting California from going ahead with its 10% Medi-Cal rate reduction. More than a month later, in late March, the Ninth Circuit Court of Appeals denied a request by the California Department of Health Care Services to suspend the preliminary injunction.

Then in October, the Ninth Circuit Court of Appeals heard the state of California's appeal of the injunction blocking the implementation of a reimbursement reduction. A ruling on the appeal had been expected late this year or in early 2013.

In the spring of 2011, the California Legislature passed and Gov. Jerry Brown signed AB 97, which included a 10% reimbursement rate cut for doctors, dentists, pharmacists and other Medi-Cal health care providers. Federal approval was required before the state could implement its proposed cuts.

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