PRNewswire - December 23, 2003

-- AHF Will Appeal Decision on Cuts to Medi-Cal Managed Care

LOS ANGELES, Dec. 23 /PRNewswire/ -- AIDS Healthcare Foundation (AHF), the largest AIDS organization in the US and operator of free AIDS treatment clinics in the US, Uganda, South Africa, and Honduras, announced that a federal judge has issued a preliminary injunction preventing the California Department of Health Services from instituting a 5% reduction in reimbursement rates to medical providers -- physicians, pharmacists, health clinics, managed care plans -- for care and services they provide to patients under the state's Medi-Cal (Medicaid) program. The five percent cut, scheduled to go into effect January 1, 2004, would wreak havoc with the health and welfare of millions of Californians covered under Medi-Cal. The DHS' failure to take this impact into account when making this reduction rendered it illegal, and was one of the bases for the injunction.

"Christmas has come early for millions of Californians," said Michael Weinstein, President of AHF. "Come the new year, they will find that they still will have some access to quality medical care for themselves and their families."

AHF, a nonprofit corporation that provides medical and pharmacy services to some 5,500 people in California with HIV/AIDS regardless of ability to pay, became involved in this issue because the Medi-Cal program is one of the largest insurers of people with HIV/AIDS in California. AHF brought this suit along with the California Medical Association (CMA), and more than a dozen other California physicians, pharmacists and health care providers.

The DHS has been enjoined from making this cut pending a full decision on the merits of the case. However, "the Court's action today sends a strong signal that it believes that the DHS' action will not withstand scrutiny.

Hopefully, this also will be the death knell for an additional 10% cut that has been proposed. The new administration in Sacramento must know that it cannot solve the State's financial crisis on the backs of its neediest people."

The injunction does not cover proposed cuts for managed care plans. AHF, which operates a Medi-Cal managed care for people with HIV/AIDS that has saved the DHS millions of dollars over the past eight years, intends to appeal this part of the ruling. "The logic in both settings is the same," said Weinstein.

"The damage to Medi-Cal recipients from DHS' arbitrary rate reduction in fee for service also extends to those receiving care from managed care plans."

SOURCE AIDS Healthcare Foundation

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