Supreme Court Seeks Solicitor's Viewpoint On Medi-Cal Reimbursement Rate Reductions

The U.S. Supreme Court May 24 invited the U.S. solicitor general to weigh in on whether California could legally reduce payments to certain medical service providers under its Medicaid program (Maxwell-Jolly v. Independent Living Centers of Southern California Inc., U.S., No. 09-958, interim order 5/24/10).

The state filed a petition for a writ of certiorari in the high court February 16, seeking review of a pair of federal appeals court rulings that said California violated Medicaid Act requirements by cutting Medi-Cal reimbursement rates in response to the state's budgetary crisis (45 HCDR, 3/10/10).

According to the state's petition, the U.S. Court of Appeals for the Ninth Circuit held that 42 U.S.C. §1396(a)(30)(A)—which requires state Medicaid plans to ensure efficiency, economy, quality of care, and access—preempted provider reimbursement cuts enacted by the California General Assembly.

The Ninth Circuit decisions essentially allow Medi-Cal recipients and providers to bring a Section 1396(a)(30)(A) claim by invoking the supremacy clause of the U.S. Constitution despite the fact that most federal courts have found that the Medicaid Act provision is not subject to private enforcement, the petition argued.

The state filed a second petition March 24 challenging four rulings issued March 3 by the Ninth Circuit, including one in which the court upheld a preliminary injunction that halted a pay reduction for 370,000 In-Home Supportive Services (IHSS) workers.

Officials with the administration of Gov. Arnold Schwarzenegger (R) claimed high court review was needed because the federal government is underfunding mandated programs. The California Association of Public Authorities for IHSS representatives, however, said the pay cuts would reduce the quality of IHSS care for 450,000 low-income seniors.

The court has not yet taken action on the second petition.