Belshe

In this appeal from a judgment granting a petition for writ of mandate, we consider the responsibilities of health care providers and the Department of Health Services (Department) for accurate reimbursement of Medi-Cal claims. (See Welf. & Inst. Code, § 14000 et seq. [all subsequent statutory references are to the Welfare and Institutions Code unless otherwise indicated].) We conclude the trial court erred in granting a writ of mandate to compel the Department to audit cost reports filed by plaintiff Kaiser Foundation Hospitals (Kaiser). We shall therefore reverse the judgment.

Statutory and Regulatory Framework

To place the issues of this appeal in their proper context, we first outline the statutory and regulatory framework of the Medi-Cal program.

As the California Supreme Court recently described in Robert F. Kennedy Medical Center v. Belshé (1996) 13 Cal.4th 748 [ 55 Cal.Rptr.2d 107 , 919 P.2d 721 ]: “The Medi-Cal program (§ 14000 et seq.) represents California’s implementation of the federal Medicaid program ( 42 U.S.C. §§ 1396 -1396v), through which the federal government provides financial assistance to states so that they may furnish medical care to qualified…