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Court ruled against injunction to stop a 10 percent medical-cuts of doctor's fees

31 07 08 - 14:15



Court won't halt Medi-Cal cuts
Injunction to stop 10% reduction in fees to providers denied by state judge
By Victoria Colliver - San Francisco Chronicle

While acknowledging cuts to the state's Medi-Cal program will make it harder for the poor to get care, a state court refused to stop a 10 percent reduction in the program's fees to doctors, dentists and other health care professionals that went into effect July 1.

A Los Angeles Superior Court judge late Tuesday ruled against a preliminary injunction sought by a group of health care providers to halt the fee cuts.


Members of the group suing the state are considering appealing the decision. "This legal fight is not over, either in federal or state court," said Craig Cannizzo, attorney for the coalition that filed the suit in May.

The court determined federal law doesn't allow private parties to sue over excessive rate cuts and those concerns should be addressed by the federal government. The case was originally filed in state court, moved to federal court, but then was sent back to the state.

The state Legislature in February approved the deep cuts for Medi-Cal providers as part of its plan to curb the state's huge budget deficit, which is now estimated at more than $17 billion.

Medi-Cal, which provides health services to about 6.6 million low-income Californians, already spends less per enrollee than any other state Medicaid program and reimburses its providers at among the lowest rates in the country.

"Nearly 7 million Californians are still having a hard time seeing a doctor, getting their prescriptions filled and getting their health care needs met. This is going to set back the health care safety net," said Ned Wigglesworth, spokesman for the California Medical Association, one of the groups suing the state.

Wigglesworth said the cuts reduce the reimbursement rate for a basic physician visit from $24 to $21.60 - "less than the price of a large pizza." He said doctors need to make at least $30 to $35 per visit to break even.

Pharmacists, patients and advocates who filed a separate lawsuit over the Medi-Cal cuts have been caught in their own legal rollercoaster in federal court.

The Ninth U.S. Circuit Court of Appeals in San Francisco temporarily blocked the cuts for pharmacists on July 11, but then reversed its decision five days later.

The three-judge appeals panel sent that lawsuit back to a federal judge in Los Angeles to reconsider the case and decide whether to issue an injunction blocking the cuts. A hearing is set for Friday.

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