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2003-12-12 -- Suit Against Medi-Cal Cuts

This is from Lynn Carmen, attorney in the lawsuit against San
Francisco which forced the Board of Supervisors to accept
responsibility for public health and safety-net healthcare by making
budget decisions on the basis of services cut, rather than simply
dollars cut.

He is currently in a suit to prevent cuts in Medi-Cal provider
re-imbursements.

The next hearing is Wednesday, Dec 17, 10:00 AM, in Sacramento, at US
District Court, 5th and I Streets.  He would welcome anyone's coming
to support this action.  Please contact him at  a7827@comcast.net , or
fax him at 415-499-1687.

What follows is a letter about the last court appearance on this
matter, which looked promising.



Dear Folks:

We had a hour and a half hearing before Chief District Judge David
F.Levi, U.S. District Court, in Sacramento, on December 3d.

We introduced Dr. Lee Strandberg's survey of the  130 members of the
California Korean Pharmacists' Assn., together with the opinion of
Professor Paul Lofholm, of UCSF, who stated that if the 5 percent cut
goes through, that pharmacies with high percentage of Medi-Cal Rxs
will be forced to cut staff, cut delivery services, cut the time for
questioning to determine if the patient is on a contra-indicated
course of medicine, and cut the time for counseling patients as to how
to safety and  efficaciously take their prescribed medicine; and that
this will force the reduced staff to process more RXs per hour,
drastically increasing THE RISK OF PRESCRIPTION ERRORS; and that on a
scale of 1 to 100, that it is a 100 that deaths will occur as a result
of the 5 percent rate cut.

The judge heard the arguments and then told both sides to file closing
briefs by Wednesday, Dec. 10th. There will be further oral argument
before Judge Levi AT 10 A.M. ON DECEMBER 17TH, IN COURTROOM 7, 14TH
FLOOR, U.S. COURTHOUSE AT 5TH AND "I"  STREETS, SACRAMENTO, -- at
which time the CMA case will also be argued.

I believe the judge may consolidate both our case and the CMA case
into one, so that he can rule on both cases as one, with only one
judgment and opinion.

The judge appeared satisfied that our two Medi-Cal beneficiaries have
standing to sue, but did not let it be known which way he stood on the
issue of whether providers also have standing to sue to enforce the
federal/state Medicaid Act.

He positively stated that the State has a duty to set rates high
enough so that quality care can be provided, which he said, -- as we
have argued all along, -- that quality services cannot be provided if
Medi-Cal does not even pay the costs to acquire and dispense, (let
alone, a reasonable profit).

I believe the judge is going to rule in favor of beneficiaries and
possibly in favor of providers, and issue the injunction to restrain
the 5 percent cut, on December 17th.

So long as he rules in favor of beneficiaries then we win the case.
If he also rules that providers have a right to enforce the Medicaid
Act, then, even better.

So, I believe that we are going to prevail at the December 17th
hearing.

Best regards,

Lynn S. Carman
Attorney for Plaintiffs in this
Pharmacy Defense Fund litigation