Bonta'

Sierra Vista Regional Medical Center v. Bonta'

Good Law
107 Cal. App. 4th 237·132 Cal. Rptr. 2d 9·2003 Cal. App. LEXIS 432·2003 Daily Journal DAR 3157·2003 Cal. Daily Op. Serv. 2522
Court of Appeal of CaliforniaFebruary 19, 2003No. C041202California5,046 words

Opinion

lead Opinion

Nicholson, J.

Pursuant to an agreement, plaintiff hospital is reimbursed by the state for medical services it provides to beneficiaries of the Medi-Cal program. The agreement called for the state to reimburse plaintiff for providing inpatient care in its neonatal intensive care unit at a rate which was greater than the rate agreed upon for other services. The state determined plaintiff had wrongfully sought reimbursement for services which did not qualify as neonatal intensive care services. Plaintiff unsuccessfully challenged the state’s decision administratively, then challenged the decision by means of a petition for writ of administrative mandate. The trial court denied the petition and entered judgment in favor of the state. We affirm the judgment.

Statutory Background

1. Medi-Cal Provider Agreements

Through the Medi-Cal program, the Legislature intended to provide health care to the aged and other persons who lacked sufficient income to meet the costs of health care. (Welf. & Inst. Code, § 14000.) In 1982, the Legislature established a system by which the State Department of Health Services (Department) could contract with individual hospitals for the provision and payment of…

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