Belshe

Little Company of Mary Hospital v. Belshe

Good Law
1997 Cal. App. LEXIS 170·53 Cal. App. 2d 325·53 Cal. App. 4th 325·61 Cal. Rptr. 2d 626·97 Daily Journal DAR 3135
Court of Appeal of CaliforniaMarch 5, 1997B087890California1,524 words

Opinion

Opinion

Ortega, J.

Appellant Little Company of Mary Hospital (Hospital) provides inpatient services under the California Medical Assistance Program (Medi-Cal). The Hospital unsuccessfully sought a writ of mandate to direct respondent Director of the California Department of Health Services (Department) to rescind as untimely the revised final settlement of the Hospital’s Medi-Cal reimbursement for the 1984 fiscal year. We affirm the judgment.

Background

The method by which the Department reimburses Medi-Cal hospital providers is explained in detail in Robert F. Kennedy Medical Center v. Belshé (1996) 13 Cal.4th 748, 751-752 [ 55 Cal.Rptr.2d 107 , 919 P.2d 721 ] (Kennedy). Briefly stated, Medi-Cal hospital providers receive interim estimated payments of Medi-Cal reimbursement during each fiscal year, with retroactive adjustments occurring at the end of each fiscal year when actual costs are known. (Cal. Code Regs., tit. 22, §51536, subds. (c)(2) & (d).) Within four months of the end of each fiscal year, the hospital submits a cost report based on actual costs. ( 42 C.F.R. § 413.24 (f)(2) (1996).) The Department makes a tentative settlement based on the hospital’s unaudited cost report,…

Sign in to read the full opinion

Create a free account to read the complete opinion text, citation history, and good-law status for this case.