North State pharmacies denied

After a ruling last year by the First District Court of Appeal of California that managed health care plans don’t have to consider how much pharmacies pay for prescription medication when setting Medi-Cal reimbursement rates, pharmacies across the North State revolted. They challenged the rates set by their managed care network, Partnership HealthPlan of California, arguing that Medi-Cal reimbursement rates have driven pharmacies out of business and discouraged others from serving the program’s beneficiaries. They also challenged the ruling.

In 1997, a federal court ruled that states must consider cost to health care providers when setting Medi-Cal reimbursement rates, according to California Healthline. But the First District Court of Appeal of California overturned that ruling last year, maintaining that regulators can ensure access to care through various means and don’t have to take cost to providers into account.

The California Supreme Court unanimously denied review of the case on June 11, setting a binding precedent for future trial court cases in the state.