Conlan

Conlan v. Shewry

Good Law
131 Cal. App. 4th 1354·2005 Cal. App. LEXIS 1272·2005 Daily Journal DAR 9894·32 Cal. Rptr. 3d 667·2005 Cal. Daily Op. Serv. 7288
Court of Appeal of CaliforniaAugust 15, 2005A106278California12,907 words

Opinion

Opinion

Pollak, J.

Nearly three years ago, this court interpreted state and federal law governing Medi-Cal, California’s implementation of Medicaid, to require that beneficiaries receive reimbursement for covered medical expenses incurred during the three-month period before they apply for assistance (the retroactivity period). (Conlan v. Bontá (2002) 102 Cal.App.4th 745 [ 125 Cal.Rptr.2d 788 ] (Conlan I).) In order to comply with federal law, we held the California Department of Health Services (DHS or the Department) must provide a means by which those who incur covered expenses during the retroactivity period may either obtain reimbursement directly from the Department or compel their providers to obtain reimbursement on their behalf. (Id. at pp. 753-754.) Although acknowledging that “[t]he manner in which the Department chooses to meet its obligations is within the discretion of the Department,” the trial court was directed to “issue a writ of mandate pursuant to Code of Civil Procedure section 1085 directing the Department to adopt and implement procedures consistent with this opinion to ensure that Medi-Cal recipients entitled to reimbursement for covered services obtained during the…

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