Plaintiffs in federal litigation to halt reimbursement cuts to Medi-Cal, California's Medicaid program, have filed a request for a review of the case.

Medi-Cal, California Medical Association (CMA) et al. v. Douglas, California's Medicaid program, reimbursement cuts, National Association of Chain Drug Stores, NACDS, Steve Anderson, California Medical Association, Paul Phinney, California Pharmacists Association, CPhA, Jon Roth, Affordable Care Act, Medi-Cal providers, Healthy Families Program, U.S. Ninth Circuit Court of Appeals, Medi-Cal reimbursements, community pharmacies, pharmacy care

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Request filed to rehear Medi-Cal case

January 29th, 2013

ARLINGTON, Va. – Plaintiffs in federal litigation to halt reimbursement cuts to Medi-Cal, California's Medicaid program, have filed a request for a review of the case.

The National Association of Chain Drug Stores, one of the plaintiffs in the case, California Medical Association (CMA) et al. v. Douglas, said Tuesday that the request comes after a decision last month by a three-judge panel of the U.S. Ninth Circuit Court of Appeals reversed an earlier ruling to uphold an injunction blocking a 10% reduction in Medi-Cal reimbursements.

NACDS, CMA and other plaintiffs in the case — the California Pharmacists Association (CPhA), California Hospital Association (CHA), California Dental Association (CDA), California Association of Medical Product Suppliers (CAMPS), AIDS Healthcare Foundation (AIDS) and American Medical Response (AMR) — had 45 days from the date of that decision to ask for an en banc review, in which the court's full bench of judges, not just a panel, would review the case. During that time, the injunction issued by the federal district court has remained in place.

The plaintiffs contend in their petition that reducing Medi-Cal payments will force health care providers out of the program at a time when millions of new patients will be diverted into the system.

"Cutting payment to Medi-Cal providers by 10% will have a huge impact on patient access to care," CMA president Paul Phinney said in a statement. "The state is in much better fiscal shape now than when these cuts were initially proposed in 2011, and with millions of new Medi-Cal patients entering the program under the Affordable Care Act, the elimination of the Healthy Families Program and the shift of dual-eligible patients, we simply cannot continue to cut resources and expect successful implementation of health reform in California."

CMA, CPhA and CDA have successfully sued in the past to enjoin earlier Medi-Cal cuts and expect to again show that federal law, which ensures that Medi-Cal patients have equal access to health care, wasn't followed, NACDS said, adding that this decision was made by the Ninth Circuit Court of Appeals.

"California is working hard to implement the Affordable Care Act, which includes moving 5 million Californians into the Medi-Cal system, plus another million children from Healthy Families into Medi-Cal," stated Jon Roth, chief executive officer of CPhA. "If the Medi-Cal provider cuts are implemented, it will have a disastrous effect on real health care reform and will cause irreparable damage to California's most vulnerable citizens. The California Pharmacists Association and other providers will continue to fight these cuts in order to protect access to care for all Californians."

NACDS said the injunction on the Medi-Cal cuts will remain until the full Ninth Circuit Court of Appeals has ruled.

The Federal District Court's February 2012 ruling stated that "California’s fiscal crisis does not outweigh the serious irreparable injury patients would suffer absent the issuance of an injunction," according to NACDS.

"Many Californians rely on services provided by community pharmacies, such as flu shots, medication counseling and health screenings. If implemented, these devastating Medi-Cal cuts could compromise patient health and access to pharmacy services, which would also drive up health care costs," commented NACDS president and CEO Steve Anderson. "We are hopeful the court will rule in favor of preserving patient access to pharmacy care."