California Medical Association and California Pharmacists Association File Suit - Department of Health Care Services Violating Federal Law
For Immediate Release Contact: Molly Weedn
October 3, 2011 916-551-2069
California Medical Association and California Pharmacists Association File Suit - Department of Health Care Services Violating Federal Law
DHCS has repeatedly rejected documents through the California Public Records Act
Sacramento - In what is a clear violation of law, California Department of Healthcare Services (DHCS) has repeatedly denied the California Medical Association’s (CMA) and the California Pharmacists Association’s (CPhA) requests for information regarding the state’s plan amendments that were submitted to the Centers for Medicare & Medicaid Services (CMS) in June. On Friday, CMA and CPhA joined together and filed a suit against DHCS to obtain the information.
"We strongly believe that the documents CMS are asking for simply do not exist," Francisco J. Silva, General Counsel and Vice President at CMA said. "Access to care for Medi-Cal patients will most certainly be impacted by the proposed cuts. The repeated refusal to share the information is a clear indication."
The California Legislature passed and Governor Brown signed AB 97, which included a 10 percent reimbursement rate cut for physicians and pharmacists, a limited number of physician visits for patients (seven) and mandatory patient co–payments on physician visits and prescription medications.
Federal approval must be granted before the state’s plan amendments can be approved. The state is required to submit underlying documents to CMS clearly documenting that access to care for Medi-Cal patients would not be impacted by the state’s plan amendments.
"We are frustrated with the State’s ‘hide the ball’ tactics and repeated refusal for transparency in their communication with CMS," said Jon Roth, Chief Executive Officer at CPhA. "These cuts will have a serious impact on patient’s access to critical medications, pharmacist services and physician offices – they owe it to all Medi-Cal patients to be open with our requests," Roth said.
Because California Medi-Cal rates are already extremely low and many prescription medications are reimbursed at breakeven, many providers cannot afford to participate. Kaiser State Health Facts lists California as the lowest reimbursed state in the nation. The copayments and arbitrary limits on services will create additional barriers for sick, vulnerable patients seeking care and ultimately, they will be forced to delay care or use emergency rooms for basic health services.
"We’re joining together with our partners in this suit because we believe that access to care is a crucial component of making health care reform in California a success," CMA CEO Dustin Corcoran said. "The state is trying to find a short term budget solution by cutting access to care for the poorest and most vulnerable Californians."
CPhA’s Roth agrees, "It is a well-documented fact that if patients do not have access to physicians and cannot afford their medications, they end up in the emergency room. That means patients are sicker and the entire health care system will pay more to treat them."
