28 January 2009

Seeking relief in the courts

So, California ER docs are suing the state of California over low reimbursement rates from Medi-Cal, the state insurance program for the indigent.

Well isn't that interesting

It's hard not to see this, coming as it does on the heels of the California Supreme Court's prohibition on balance billing, as a planned step in a coordinated strategy, especially as it involves several large ER groups.   But I don't think so.   It's reactionary -- in response to the recent budget cuts, I think, rather than being logically related to the balance billing issue.   And I am not sure how well-thought-out it truly is.  Sure, it provides a platform to get out the rhetoric that the ER safety net is unraveling, and it highlights the disgrace that is medicaid reimbursement nation-wide.   But if the suit is without merit, constructed on a shaky legal theory, as I suspect it is, it will be dismissed or otherwise lost.   That will neutralize any momentum towards reforming the Medi-Cal payment system and set the cause back quite a bit.

Maybe I'm wrong -- I hope so.   Apparently the CMA won an injunction stopping a 10% across-the-board pay cut, so there may be grounds for this suit.   But it's a big risk, and I hope it doesn't backfire.

Anyway, I can't see a less opportune time to file this suit -- the state's essentially bankrupt.


physasst said...

Yeah, I agree with you, as with most things, timing is paramount, and this is just an abyssmal time to think of something like this.

I can't think of what they really think they might accomplish right now with this.

Anonymous said...

i'll be watching with great interest, but mostly expect it to accomplish nothing except make the public hate doctors for being "greedy"

Anonymous said...

at least the lawyers they hire will make money off of this. good for them.

JimII said...

Anons 5:09 & 5:12, do you find it strange at all to put quote marks around greedy when referring to the notion that there is something wrong with folks in the medical profession being paid what they are worth, and then posting three minutes later out of the exact same perception but of the legal profession? Are you being ironic? (BTW, obviously doctors are more valuable than lawyers, but the average lawyer in SEA makes $95K, while the average MD makes $154K. Source:Indeed.com)

JimII said...


If there are reasonable grounds for the action, I don't know that it necessarily is a bad idea. It might very well show the government doctors are serious about demanding fair compensation, and drive a settlement or the legislative equivalent of one.