Belshé

Eden Hospital District appeals from the trial court’s denial of a petition for writ of mandate by which the hospital district sought to reverse a decision by the Director of the Department of Health Services regarding payment for services rendered to Medi-Cal patients. Appellant contends the administrative decision was not supported by substantial evidence.

Statement of the Case and Facts

Under the Medi-Cal program, the amount hospitals are reimbursed for inpatient services provided to Medi-Cal recipients is limited by formulas set forth in the regulations implementing the program. Pursuant to statute and regulations, during the years 1989 and 1990, appellant received interim payments for inpatient services rendered to Medi-Cal patients. Thereafter, the department audited appellant’s cost reports and determined, after application of the “maximum inpatient reimbursement level” (MIRL)—a limitation on reimbursement calculated by multiplying an “all-inclusive rate per discharge” by the number of Medi-Cal discharges in a given year—that appellant had received overpayments for these years.

Appellant was informed in August 1993 that the department had determined its liability…