[NYAPRS Enews] MNT: Supreme Court to Consider if States Can Reduce Medicaid Payments

[Harvey Rosenthal]

Supreme Court To Hear Arguments Over Medicaid Payments

Medical News Today  January 20, 2011

 

At issue is whether California and other financially challenged states
have the leeway to reduce Medicaid payments to doctors, hospitals and
other medical providers.

Los Angeles Times
<http://smtp01.kaiserhealthnews.org/t/17224/537253/16361/0/> : U.S.
Supreme Court To Decide If California Can Cut Payments To Medi-Cal
Providers
The U.S. Supreme Court announced Tuesday that it will decide whether to
give California and other cash-strapped states more freedom to cut the
amounts they pay doctors, hospitals and other providers of medical care
for the poor (Savage and Goldmacher, 1/19).

McClatchy
<http://www.mcclatchydc.com/2011/01/18/107002/supreme-court-takes-on-sta
tes.html#storylink=misearch> : Supreme Court Takes On States' Plans To
Cut Medicaid Payments 
The Supreme Court agreed Tuesday to review California's controversial
proposals to cut Medicaid reimbursements to physicians, dentists,
pharmacies, health clinics and other medical providers. The court's
decision to hear three combined California legal challenges is good news
for Democratic Gov. Jerry Brown, who wants to enact budget cuts similar
to those that courts have previously struck down. Potentially, hundreds
of millions of dollars in proposed savings are at stake (Doyle, 1/18).

KQED <http://www.californiareport.org/archive/R201101180850/a> : High
Court Considering California Drug Price Suit 
The U.S. Supreme Court will hear arguments on Wednesday in a California
case over drug prices. At issue is a question over whether clinics that
serve low-income patients are being overcharged by pharmaceutical
companies (Varney, 1/18).

Modern Healthcare
<http://www.modernhealthcare.com/article/20110118/NEWS/301189965> : High
Court To Hear Challenges To Medicaid Cuts 
The U.S. Supreme Court has agreed to hear arguments on three
consolidated California cases that challenge Medicaid provider payment
cuts. The high court said it would hear one-hour oral arguments on the
three cases, most likely in the fall. In all three cases, providers sued
the California Department of Health Care Services to halt planned rate
cuts that state officials said were necessary amid a severe budget
crisis (Vesely, 1/18).

________________________________

http://www.medicalnewstoday.com/articles/214253.php 

----------------

U.S. Supreme Court To Decide If California Can Cut Payments To Medi-Cal
Providers

Justices Will Decide Whether To Allow The Cash-Strapped State To Reduce
What It Pays To Doctors, Hospitals And Other Providers Of Healthcare For
The Poor.

By David G. Savage and Shane Goldmacher, Los Angeles Times January 19,
2011

	

The U.S. Supreme Court announced Tuesday that it will decide whether to
give California and other cash-strapped states more freedom to cut the
amounts they pay doctors, hospitals and other providers of medical care
for the poor.
The case could have a major impact on Gov. Jerry Brown's plans to close
the state's massive budget deficit.
Federal courts previously blocked about $1 billion in Medi-Cal cutbacks
adopted by the Legislature in 2008. Brown has proposed trying those cuts
again. His budget plan would reduce the amounts the state pays
healthcare providers by 10%, which would reduce the program by $719
million.
Many other states have indicated an interest in making similar cutbacks.
Twenty-two states joined California in its appeal to the Supreme Court.
Attempts in California to trim spending on Medi-Cal and other health
programs have repeatedly been tied up in the courts. Former Gov. Arnold
Schwarzenegger once criticized federal judges for "going absolutely
crazy" in their continued blockage of attempted spending reductions.
Brown spokeswoman Elizabeth Ashford said the federal courts had been a
"roadblock" in allowing California to balance its budget. The issue
before the high court, she said, was a matter of "state sovereignty."
"It's incredibly important," she said of the high court's decision to
consider the case. "The fact that they are taking this up indicates that
they understand how important this issue is to the state."
But medical groups said the state's plans would essentially deny
healthcare coverage to hundreds of thousands of people by driving
doctors from the program.
Currently, 57% of California doctors accept new Medi-Cal patients,
according to a study published last year by the California HealthCare
Foundation. That number would drop further if the state reimburses
doctors less, said Anthony Wright, executive director of Health Access,
a consumer advocacy group.
About seven million Californians get their health coverage through
Medi-Cal.
"The practical effect" of the state's cutbacks "is that it makes it
harder for the millions of Californians on Med-Cal to get in to see a
doctor," Wright said.
The California Medical Assn., which represents 35,000 doctors, called
the state's existing Medi-Cal payment rates "ridiculously low - among
the lowest in the nation."
Cutting them further "would only serve to force more doctors out of the
program and decrease access to care for millions of poor and unemployed
Californians," the association's president, James Hinsdale, said in a
statement. "Regardless of the legal issues involved, slashing Medi-Cal
rates is bad public policy that would undermine the state's healthcare
system."
The program of healthcare for the poor, known as Medicaid nationally and
Medi-Cal in California, is funded jointly by the federal government and
the states. The law is unclear on how far states can go to reduce the
amount they pay to providers.
After California's cutbacks in 2008, doctors, hospitals, pharmacies and
other providers sued in federal court. They argued successfully that the
cutbacks were so steep that poor patients would no longer have access to
acceptable healthcare and that the cuts were preempted by the federal
Medicaid Act.
But lawyers for then-Atty. Gen. Brown appealed to the Supreme Court.
They argued that private parties, such as doctors, had no right to sue
the state and no right to a particular reimbursement payment.
This appeal touched a chord in the high court. Chief Justice John G.
Roberts Jr., among others, has been skeptical of the notion that when
the federal government provides public money for benefits such as health
or education, federal law authorizes suits by those unhappy with the
level of spending.
The Obama administration so far has sided against the state. In
December, the Justice Department told the high court it should turn down
California's appeal.
Instead, the justices agreed to hear three separate appeals from the
state, all of which raise the same issue. The lead case is Maxwell-Jolly
vs. Independent Living Center of Southern California.

http://www.latimes.com/news/local/la-me-court-medicaid-20110119,0,405868
.story

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