Bonta

RCJ Medical Services, Inc. v. Bonta´

Good Law
111 Cal. Rptr. 2d 223·2001 Cal. App. LEXIS 663·2001 Daily Journal DAR 9085·91 Cal. App. 4th 986·2001 Cal. Daily Op. Serv. 7384
Court of Appeal of CaliforniaAugust 23, 2001B143160California10,746 words

Opinion

Opinion

Turner, J.

I. Introduction

This case involves a postpayment audit of a Medi-Cal provider’s claims. Such audits are required under both federal and state law. ( 42 C.F.R. §§ 447.45 (f)(2), 456.3 (2000); Welf. & Inst. Code, § 14170, subd. (a)(1).) No Medi-Cal payments were withheld from the provider.

The California Department of Health Services (DHS) administers MediCal, the federal Medicaid program in California. The DHS contracted with the California State Controller’s office (the Controller) to audit Medi-Cal payments to providers. The Health Care Financing Administration (HCFA), part of the United States Department of Health and Human Services, is the federal agency responsible for administering the Medicaid program. On December 17, 1999, the HCFA, a federal agency, specifically approved in writing the DHS’s delegation of audit authority to the Controller.

This appeal is from a judgment granting a peremptory writ of administrative mandate directed at defendant, the Director of the DHS. The peremptory writ of mandate requires the DHS to set aside its final decision in the administrative appeal of RCJ Medical Services, Inc. (RCJ), “insofar as it relies upon the audit findings of…

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