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Medi-Cal court ruling a ‘recipe for disaster’

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SACRAMENTO, Calif. — The California Pharmacists Association (CPhA) has denounced a federal appeals court for refusing to review a ruling that lowered the state’s Medicare reimbursement rates.

The association says that with 4 million new beneficiaries coming into the system under the Affordable Care Act, “this decision is a recipe for disaster.’’

CPhA’s outrage comes after a U.S. 9th Circuit Court of Appeals denied a request from the association and other health care coalition members for a review of a three-judge panel’s earlier decision to overturn several injunctions that prevented implementation of the 10% Medi-Cal reimbursement cuts passed by the California Legislature in 2011 (AB 97).

“While not surprising, we are deeply disappointed in the decision and absolutely believe it will result in harm to Medi-Cal patients,” said Jon Roth, chief executive officer of CPhA. “It is absurd to think you can slash reimbursement rates, resulting in pharmacists providing services below their actual costs, while at the same time expanding the Medi-Cal program to 4 million additional beneficiaries under health care reform beginning in 2014 — I am astonished that the state thinks this will work.”

In their earlier decision, the three-judge panel determined the court appropriately deferred to a Centers for Medicare & Medicaid Services decision that approved the state plan allowing the cuts to providers.

“At this point we are weighing all our options, including a petition to the U.S. Supreme Court,” Roth said.


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