Healthcare Business News

Court: Medi-Cal must cover podiatrists, dentists

By Associated Press 
Posted: July 5, 2013 - 5:30 pm ET

California lawmakers improperly stopped funding certain medical services that rural and other specialized health clinics provided to low-income residents under the state's Medicaid program, a federal appeals court ruled Friday.

A three-judge panel of the 9th U.S. Circuit Court of Appeals reversed the finding of a trial judge and said federal law requires states participating in Medicaid to reimburse clinics serving migrant workers, homeless people and other poor populations for "a panoply of medical services to under-served communities" that includes chiropractic care, dental care, optometry, podiatry and speech therapy.

To save money, the Legislature in 2009 eliminated coverage for adults receiving those services through the state's Medicaid program, known as Medi-Cal, saying they were optional because they were not provided by medical doctors.

Although the CMS ultimately authorized the move, the 9th Circuit panel said only Congress can change the terms of Medicaid coverage, which are now written to mirror the services covered by the government's health insurance program for the elderly and disabled, Medicare.

Because Medicare "unambiguously defines the Clinics' services to include services performed by dentists, podiatrists, optometrists and chiropractors, in addition to services provided by doctors of medicine and osteopathy," eliminating those services for Medi-Cal recipients "would do violence" to the program, Judge Dorothy Nelson said.

The ruling came in a lawsuit brought by the California Association of Rural Health Clinics and Avenal Community Health Center, a clinic in Kings County.

The case was one of several challenges healthcare providers and patients have brought over Medi-Cal cuts state officials made while trying to balance California's budget.

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