Judge Upholds Injunction Against
Cuts to Medi-Cal Reimbursement
[Posted 02/12/04]

A federal judge has denied a request by the state Department of Health Services (DHS) to reconsider its Dec. 23 ruling that the state's 5 percent cut to Medi-Cal reimbursement rates was illegal.

U.S. District Judge David F. Levi said in yesterday's ruling that the DHS did not produce any new evidence or information that would cause the court to reconsider its earlier decision. In December, Judge Levi ruled that the cuts scheduled to take effect on Jan. 1 could not stand. In that ruling, he said that the state of California failed to consider how the hundreds of millions in cuts would affect access to care for poor, disabled, elderly, and children whose health care is provided by Medi-Cal.

CMA and other health care advocates had filed a lawsuit last fall, citing the Social Security Act, which says that a state plan for medical assistance (Medi-Cal in California) must assure that payments are “consistent with … economy and quality of care,” and are sufficient to enlist enough providers so that services are available at a level equal to those available to the general public. According to the lawsuit, the number of primary care physicians per capita for Medi-Cal patients was one-third less than for the general population using 2001 figures from the Medi-Cal Policy Institute. The figure for specialists is 50 percent less than for the general population; and for surgeons it is two thirds less. Further cuts would have made the disparities larger.

Despite the preliminary injunction, the new gubernatorial administration has proposed an additional 10 percent in Medi-Cal reimbursement rate cuts in this year’s state budget.

Contact: CMA Government Relations, 916/444-5532 or hcampbell@cmanet.org.