Welcome to the Department of Health Care Services Welcome to Medi-Cal Welcome to the Department of Health Care Services

Medi-Cal Logo

Medi-Cal Payment Reduction Update

December 18, 2012

On Thursday, December 13, 2012 the Ninth Circuit Court of Appeals issued a ruling that vacated injunctions related to Medi-Cal provider payment reductions. The court found that the Department of Health Care Services (DHCS) does have authority to reduce Medicaid rates. Generally, payments to the following provider types will be impacted by the ruling: Emergency and Non-Emergency Medical Transportation, Pharmacy, Durable Medical Equipment and Supplies, Physicians, Dental, Clinics and Distinct Part Nursing Facilities Level B. The payment reductions will be implemented after the decision becomes final. The plans to implement these previously enjoined reductions will be communicated with providers well in advance of the effective date. Recoupments for previously paid claims that were subject to the payment reductions will not begin until after the payment reductions are implemented.

To receive updates on critical Medi-Cal news via email, providers are encouraged to subscribe to the Medi-Cal Subscription Service (MCSS), free of charge, using the MCSS Subscription Form.