Johnson v. Cal. Dept. of Health Care Services CA2/2

BACKGROUND

I. Statutory and Regulatory Context

A. Medicaid and Medi-Cal “Medicaid is a cooperative federal-state program” (Douglas v. Independent Living Center of Southern California, Inc. (2012) 565 U.S. 606, 610 (Douglas)) that subsidizes the states’ provision of medical care to certain families and individuals with insufficient income and resources to meet the costs of necessary medical services (Armstrong v. Exceptional Child Center, Inc. (2015) 575 U.S. 320, 323 (Armstrong)). A state’s participation in Medicaid is voluntary, but a state that chooses to participate “must comply with federal requirements and administer its Medicaid program through a plan approved by the federal Centers for Medicare and Medicaid Services (CMS). [Citations.]” (Dignity Health v. Local Initiative Health Care Authority of Los Angeles County (2020) 44 Cal.App.5th 144, 152.) Before approving a state’s Medicaid plan, CMS reviews it and any amendments “to determine whether they comply with the statutory and regulatory

All further statutory references are to the Welfare and Institutions Code unless otherwise indicated.

2 requirements governing the Medicaid program. [Citations.]” (Douglas,…