Tentative Ruling Grants Injunction Against Medi-Cal Provider Rate Reductions   

The CMA has led a provider coalition in seeking injunctive relief to block implementation of the 10% Medi-Cal provider rate reduction approved as part of the state budget for 2011-12. The reduction was to take effect on June 1, 2011 but was not approved by CMS until September. DHCS had announced their intent to implement the 10% reduction for all physician services, except those to children in certain settings, and then recoup prior "overpayments" going back to June 1, 2011. Yesterday Judge Snyder in Federal District Court  issued a 25-page tentative ruling granting the preliminary injunction. The judge took the matter under submission following oral arguments yesterday morning.   We expect her to issue a final decision within a week.  In the meantime, the injunction is not in effect and the state may continue to process claims with the 10% reduction. We do not believe that they had yet reduced rates for radiology services. It is unclear at this time whether the injunction will be applied retroactively to the June 1, 2011 effective date of the cuts.  We expect the State to file an immediate appeal of the final decision.

We will keep you informed on the final details of the injunction.