Calif. Hospital Association Urges Court To Block Medi-Cal Cuts
The California Hospital Association has petitioned a federal court to prevent certain Medi-Cal reimbursement cuts from taking effect, KPBS News reports. Medi-Cal is California's Medicaid program.
Background
In October, CMS approved the state's plan to reduce certain Medi-Cal payments by 10% (Goldberg, KPBS News, 11/22). State officials have projected that the cuts will save $623 million.
According to the state Department of Health Care Services, CMS has allowed the state to make a 10% reimbursement cut to:
- A number of providers and outpatient services, including clinics, dentists, laboratories, optometrists and pharmacists; and
- Freestanding nursing and adult subacute care facilities, as well as other nursing facilities.
The cuts are retroactive to June 1.
Heath care providers and patient advocates have argued that the cuts would cause more health care providers to stop treating Medi-Cal beneficiaries.
They also have said that the Obama administration could be jeopardizing the federal health reform law because the Medi-Cal system will be ill prepared to handle the large number of low-income patients who will become newly eligible for coverage (California Healthline, 11/22).
CHA filed a lawsuit in federal district court in Los Angeles against the state and HHS in an effort to block the reimbursement cuts (California Healthline, 11/3).
Details of CHA's Request
Through its request for a preliminary injunction, CHA is seeking to prevent DHCS from implementing Medi-Cal payment cuts for skilled nursing facilities in acute care hospitals (CHA release, 11/22).
According to CHA, DHCS and HHS failed to consider health care provider costs or whether reimbursements were consistent with economy, efficiency and quality of care. The complaint also argues that an assessment of how potential rate reductions would affect access to care was "fatally flawed."
Duane Dauner -- president and CEO of CHA -- added that the cuts were approved in violation of federal Medicaid law and "without regard for the welfare of thousands of patients with complex medical needs"Â (Evans, Modern Healthcare, 11/22).
In addition, CHA claims that the cuts portrayed as a 10% payment reduction could be significantly higher because they are based on fiscal year 2008-2009 rates.
Upcoming Court Hearing
The hearing for CHA's request for a preliminary injunction is scheduled to take place in federal district court in Los Angeles on Dec. 19 (CHA release, 11/22).
For additional coverage on CHA's pursuit of an injunction against the cuts, see today's Capitol Desk post.
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