The Adult Day Health Care Association (ADHCA) recently announced it would file an appeal to challenge the state of California’s 10% reduction in the provider reimbursement rate.
Berdj Karapetian, executive director of the ADHCA, said if the courts allow the state to recoup 10% of provider rates, it could be a final straw for some centers. “We are convinced that if the recoupment is to occur,” Karapetian said, “it will force many CBAS providers to close their doors. And that will further diminish the number of providers.”
Statewide, approximately 34 centers have shut down or announced plans to close over the past year. Preliminary injunctions have been granted by federal judges in four other cases challenging the 10% Medi-Cal provider rate cut. Those lawsuits were brought by hospital, pharmacy, emergency transportation and provider groups, including the California Medical Association and the California Hospital Association.
A lawsuit filed by the California Primary Care Association seeks a temporary restraining order before its federal hearing. Previously, under the Adult Day Health Care program, federally qualified health centers were paid at a higher fee-for-service rate. Now the California Department of Health Care Services wants that rate to match the one it worked out in settlement of yet another lawsuit, the Disability Rights California settlement that prompted creation of the CBAS program to replace the ADHC program.