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State can't cut Medi-Cal fees, court rules
San Francisco Chronicle ^ | 7/9/9 | Bob Egelko, Chronicle Staff Writer

Posted on 07/09/2009 12:51:19 PM PDT by SmithL

California acted illegally by trying to cut Medi-Cal fees by 10 percent last year for doctors, pharmacists and others who treat 7.1 million poor people, a federal appeals court ruled today.

The decision by the Ninth U.S. Circuit Court of Appeals in San Francisco was a victory for health professionals and their patients but a blow to the state, which is mired in a $26.3 billion budget deficit. Gov. Arnold Schwarzenegger and state legislators have imposed further Medi-Cal reductions this year, which could be thwarted by the ruling.

"The cuts that the governor is attempting will also be stopped," said Lynn Carman, a lawyer for pharmacists who sued the state. He called the ruling "a victory for Medi-Cal beneficiaries who the governor has been trying to eradicate for the last two years."

State officials had no immediate comment.

The ruling requires the state to reimburse doctors, dentists, pharmacists, clinics and adult day health care centers by the amounts that the state cut from their fees July 1, 2008. The reductions expired March 1, when smaller cuts for various Medi-Cal providers took effect, prompting another round of lawsuits.

The state has estimated that a 10 percent fee reduction would save California $500 million a year.

In today's 3-0 decision, the court said California had violated a federal law that requires states to set rates at levels that will pay for quality care and lead to equal access to health services for poor people. The federal government pays half the costs of the Medicaid program, which is called Medi-Cal in California.

State health officials and legislators did not study how the cuts would affect Medi-Cal patients and acted entirely for economic reasons,

...Smith said the hardships suffered by Medi-Cal patients who lost medical care would outweigh any financial harm to the state.

(Excerpt) Read more at sfgate.com ...


TOPICS: Government; Politics/Elections; US: California
KEYWORDS: 9thcircus; goldenstate; medical; yourtaxdollarsatwork
9th Circus trying to kill California.
1 posted on 07/09/2009 12:51:20 PM PDT by SmithL
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To: SmithL

Like they need any help.


2 posted on 07/09/2009 12:52:47 PM PDT by El Sordo
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To: SmithL

The decision by the Ninth U.S. Circuit Court of Appeals in San Francisco was a victory for health professionals and their patients but a blow to the state...

How many times can the people of CA be blown by the 9th circus before they get tired?


3 posted on 07/09/2009 12:58:58 PM PDT by Wally_Kalbacken
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To: SmithL
I have to agree with the 9th circus this time. The federal law on Medicaid has some requirements on how payments are set and California didn't follow them, instead just cutting the payments by an arbitrary amount.

Whether you like the law or not is one thing, but the 9th (for once) didn't pull their ruling out of thin air.

4 posted on 07/09/2009 12:59:44 PM PDT by KarlInOhio (Fannie Mae, Freddie Mac, AIG, Chrysler and GM are what Marx meant by the means of production.)
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To: KarlInOhio

Which section of the US Constitution grants federal government the right to regulate this?


5 posted on 07/09/2009 1:04:25 PM PDT by thesharkboy (<-- Looking for the silver lining in every cloud, since 1998)
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To: KarlInOhio

I agree. Further, this is a blow to “national healthcare” schemes. The California cut in reimbursements would have resulted in further cost shifting and rationing. Maybe California should look very carefully at all the care provided to criminal aliens. Americans do not have the responsibility for another countries healthcare.


6 posted on 07/09/2009 1:05:07 PM PDT by PA Engineer (Liberate America from the occupation media.)
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To: SmithL

So just lay off more state worker slugs to make up the difference.


7 posted on 07/09/2009 1:06:55 PM PDT by Bertha Fanation
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To: SmithL

I’m sitting here stunned (stuned) that one out of every five people in California is on Medi-Cal. Can that be true? Illegals aren’t supposed to eligible, right? Does anyone know?


8 posted on 07/09/2009 1:08:04 PM PDT by thesharkboy (<-- Looking for the silver lining in every cloud, since 1998)
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To: SmithL

This is a GOOD thing. Why should doctors take less for seeing MediCal patients.


9 posted on 07/09/2009 1:09:06 PM PDT by Little Ray (Do we have a Plan B?)
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To: thesharkboy

You take the gov’t money, play by the gov’t rules. That’s a lesson that’s lost on most people, especially those idiots who want the gov’t even more involved in healthcare.


10 posted on 07/09/2009 1:18:38 PM PDT by Tamar1973 (Only dead fish "go with the flow"--Sarah Palin)
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To: Little Ray
There are those that genuinely need something like Medi-cal but doctors don't want them as patients unless the patients can make up the difference.

I know many doctors simply will not treat Medicare/Medicaid patients.

11 posted on 07/09/2009 1:25:02 PM PDT by count-your-change (You don't have be brilliant, not being stupid is enough.)
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To: Tamar1973
You take the gov’t money, play by the gov’t rules.

Is that from the Constitution? I don't remember reading that. The federal government has no right to disburse health care money to the states. Furthermore, it has no right to collect tax money for that purpose.

12 posted on 07/09/2009 1:30:18 PM PDT by thesharkboy (<-- Looking for the silver lining in every cloud, since 1998)
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To: thesharkboy

I don’t disagree but the state should have never taken the money either.


13 posted on 07/09/2009 2:13:01 PM PDT by Tamar1973 (Only dead fish "go with the flow"--Sarah Palin)
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