News & Analysis as of

Medicaid Medi-Cal Health Care Providers

Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with... more +
Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with children.  less -
Troutman Pepper Locke

California AG Takes Action Against $1.3 Million Insurance Fraud Scheme

Troutman Pepper Locke on

In May, California’s attorney general (AG) charged a local dermatologist with more than 20 counts of fraud after uncovering a scheme that allegedly resulted in the state’s Medicaid program paying out over $1.3 million for...more

Weintraub Tobin

California Medi-Cal Enrollment Appeals: An Uphill Battle but an Essential Tool

Weintraub Tobin on

In our practices, we are seeing an increasing number of denials or de facto denials of Medi-Cal provider enrollments. The consequences of a Medi-Cal enrollment denial can be quite serious. First, a provider may not receive...more

McDermott Will & Schulte

New Laws Expand Telehealth in California

California Governor Gavin Newsom recently signed into law two bills that expand the delivery of telehealth services in the state. In particular, the legislation: • Permits providers to prescribe medications without a...more

Sheppard Mullin Richter & Hampton LLP

California Expands Medicaid Tele-Health Policy

The California Department of Health Care Services (“DHCS”) recently revised its Medi-Cal telehealth policy to allow providers increased flexibility in their use of telehealth as a modality for delivering medically necessary...more

Buchalter

California Court Endorses Percentage Billing Fees for Medi-Cal Providers

Buchalter on

California’s First District Court of Appeal (“Court of Appeal”) has recognized that percentage-based billing arrangements do not violate California’s Medi-Cal laws and that the California Department of Health Care Services...more

Herbert Smith Freehills Kramer

California Court Upholds Expansive Definition of Recoupment

The Bankruptcy Court for the Central District of California examined the scope of the doctrine of recoupment for Medicaid and related payments, allowing the deduction by the state. The court held that the California...more

Epstein Becker & Green

Supreme Court Rules That Providers and Suppliers Cannot Challenge Medicaid Reimbursement Rates in Federal Court

Epstein Becker & Green on

On March 31, 2015, a 5-4 plurality of the Supreme Court of the United States ruled that Medicaid providers do not have a private right of action under the Medicaid statute to challenge reimbursement rates. The Supreme Court’s...more

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