Deadline Nears for U.S. Supreme Court Appeal of 10% Medi-Cal Provider Cut

by David Gorn

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Last week, state officials began phased-in implementation of a 10% reduction in Medi-Cal reimbursement rates, but that doesn't mean efforts to rescind or reverse the cut have subsided, according to provider groups.

Legislative efforts to undo the decision appear to have stalled, with two bills currently sitting in committee as the state Legislature begins its final week of the session.

If the week passes without action by the Legislature, that leaves one big card left to play -- appeal to the U.S. Supreme Court.

"The deadline to appeal is Sept. 23," said Jan Emerson-Shea, vice president for external affairs at the California Hospital Association.

"So yes, it's still in the hopper as a possibility."

Two years ago, the Legislature faced a huge budget crisis and voted to impose the 10% rate cut on reimbursement for Medi-Cal providers. The cuts didn't go into effect as the decision was challenged in several court cases.

Those cases came to an end in June, when the federal Ninth Circuit Court of Appeals made its final ruling in favor of the state.

Officials from the Department of Health Care Services said the court-approved cut will be implemented in stages. The first phase -- rate reductions for medical transportation and dental providers -- started on Sept. 5.

The reimbursement rate for durable medical goods will drop starting Oct. 24, and the bulk of the cuts -- to physicians, pharmacists and clinics -- will begin Jan. 9, 2014, according to DHCS documents.

All of that could grind to a halt if the U.S. Supreme Court takes up the case.

"I don't know what's going to happen," Emerson-Shea said. "Lawyers are preparing the paperwork, so we can go forward if that's the decision. We'd be ready in that case, but no decision has been made yet."

Emerson-Shea said there's always still a chance that one of the legislative bills could rise out of committee in the next week.

"This is end of session," she said, which means sometimes things happen unexpectedly. "I don't know that they will," Emerson-Shea said. "But the issue, maybe not this particular bill, but this issue is something that is very much front and center for us."

The original deadline was at the end of August for appeal to the Supreme Court, but provider groups asked for and received a 30-day extension, to Sept. 23.

Last week, state officials began phased-in implementation of a 10% reduction in Medi-Cal reimbursement rates, but that doesn't mean efforts to rescind or reverse the cut have subsided, according to provider groups.

Legislative efforts to undo the decision appear to have stalled, with two bills currently sitting in committee as the state Legislature begins its final week of the session.

If the week passes without action by the Legislature, that leaves one big card left to play -- appeal to the U.S. Supreme Court.

"The deadline to appeal is Sept. 23," said Jan Emerson-Shea, vice president for external affairs at the California Hospital Association.

"So yes, it's still in the hopper as a possibility."

Two years ago, the Legislature faced a huge budget crisis and voted to impose the 10% rate cut on reimbursement for Medi-Cal providers. The cuts didn't go into effect as the decision was challenged in several court cases.

Those cases came to an end in June, when the federal Ninth Circuit Court of Appeals made its final ruling in favor of the state.

Officials from the Department of Health Care Services said the court-approved cut will be implemented in stages. The first phase -- rate reductions for medical transportation and dental providers -- started on Sept. 5.

The reimbursement rate for durable medical goods will drop starting Oct. 24, and the bulk of the cuts -- to physicians, pharmacists and clinics -- will begin Jan. 9, 2014, according to DHCS documents.

All of that could grind to a halt if the U.S. Supreme Court takes up the case.

"I don't know what's going to happen," Emerson-Shea said. "Lawyers are preparing the paperwork, so we can go forward if that's the decision. We'd be ready in that case, but no decision has been made yet."

Emerson-Shea said there's always still a chance that one of the legislative bills could rise out of committee in the next week.

"This is end of session," she said, which means sometimes things happen unexpectedly. "I don't know that they will," Emerson-Shea said. "But the issue, maybe not this particular bill, but this issue is something that is very much front and center for us."

The original deadline was at the end of August for appeal to the Supreme Court, but provider groups asked for and received a 30-day extension, to Sept. 23.


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