Recent Court Action on Medi-Cal Provider Rate Reductions  

We previously notified you that CMS had approved the Medi-Cal program change to implement a 10% provider rate cut for most providers that is retroactive to June 1, 2011. DHCS had not yet announced when that rate reduction would actually be implemented or a process of recoupment of amounts paid on prior paid claims.

Yesterday in Federal Court in LA there was a hearing on a request for a Temporary Restraining Order filed by pharmacy groups and disability rights organization to enjoin the 10% cut. It was agreed to by both petitioners and the AG on behalf of the Department of Health Care Services that a hearing on the TRO would occur on December 19th and that no implementation could occur until after that hearing. Depending on the outcome of that hearing the Court could enjoin the cuts or not approve the TRO and allow DHCS to implement. We will keep you informed on further developments and expect that other litigation might be initiated by a broader provider coalition.

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