Lawsuit challenges Calif. Medicaid reimbursement cuts

Cuts would violate federal laws, state pharmacy group says

SACRAMENTO, Calif. — Reimbursement cuts to California's state Medicaid program are the subject of a lawsuit filed last week in San Francisco.

The Professional Pharmacy Alliance and the California Korean American Pharmacists Association filed suit against the California Department of Health Care Services in San Francisco Superior Court over an across-the-board 10% cut in 2011 to the reimbursement rates for most providers under the program, known as Medi-Cal.

"We are pleased to see that other pharmacy organizations are as concerned as we are about the patients who will ultimately be denied access to their medications," California Pharmacists Association CEO Jon Roth said; the CPhA is among organizations supporting the lawsuit. "We have attempted to work with the state for several years to bring long-term solutions to these issues without disrupting the provider network, but DHCS has stayed the course toward implementing these devastating cuts on Jan. 9, 2014. Unfortunately, it appears that the only thing DHCS responds to these days is a lawsuit."

According to the lawsuit, the cuts violate state laws and would result in many rural and minority patients being denied access to medications. The CPhA raised similar concerns earlier this year with the DHCS and the Centers for Medicare and Medicaid Services, citing in letters multiple examples of the DHCS admitting to the CMS that the cuts would violate federal Medicaid access-to-care laws.

Login or Register to post a comment.