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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 last 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. The 10% cut applies to both payments made to pathologists as physicians and could impact you if you are reimbursed as a clinical laboratory for freestanding services. 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. The injunction if finalized would enjoin cuts to physician payments but would not stop the 10% cut to clinical laboratories. 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 pathology/physician 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.
WEBINAR
Marketing Issues for Pathologists
February 16, 2012 at NOON PST
Attorney Jane Pine Wood from McDonald Hopkins LLC presents Marketing Issues for Pathologists. She will discuss EMR donations, donations for interfaces, provision of collection supplies, placement of specimen collectors in physician offices, TC/PC arrangements, and other common pathology marketing issues.
Cost: Member: $99/Non-Member: $150
Submit Your Questions. You may submit questions that you'd like answered at the webinar. All questions must be received by Friday, February 10, 2012. Please click here to submit your questions or you may submit your questions via email to Ann Marie Jackson at ajackson@amgroup.us.
Registration Issues? Contact Monique at mrice@amgroup.us
Regards,
CSP
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