Asante et al v. California Department of Health Care Services et al

Filing 81

ORDER RE: OUTSTANDING PROVISIONS. Signed by Judge Edward M. Chen on 3/24/16. (bpf, COURT STAFF) (Filed on 3/24/2016)

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UNITED STATES DISTRICT COURT

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NORTHERN DISTRICT OF CALIFORNIA

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ASANTE, et al.,
Plaintiffs,

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ORDER RE OUTSTANDING
PROVISIONS

v.

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Case No. 14-cv-03226-EMC

CALIFORNIA DEPARTMENT OF
HEALTH CARE SERVICES, et al.,

For the Northern District of California

United States District Court

Defendants.
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Pursuant to the Court’s ruling at the hearing of March 10, 2016, and to the parties’

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stipulation and the Court’s resolution of disputes regarding this Order.

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1.

The Department shall apply the terms of this Order to all inpatient Medi-Cal services

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provided by the petitioners as of the date December 21, 2015, unless and until there is a

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further order from the Court amending monetary relief retrospectively.

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2.

defined is State Plan Amendment 15-020.

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3.

In its APR-DRG outlier calculations, the Department shall apply to the Plaintiffs the costto-charge (“CCR”) ratio calculation set forth in SPA 15-020.

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All of the Plaintiffs in this action shall be deemed to be “border hospitals” as that term is

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For purposes of APR-DRG reimbursement the following four hospitals shall be deemed to

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be “remote rural border hospitals” and shall be entitled to the higher APR-DRG base rates

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paid California “remote rural” hospitals: Sky Lakes Medical Center (Klamath Falls,

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Oregon); Asante Three Rivers Medical Center (Grant Pass, Oregon); Havasu Regional

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Medical Center (Lake Havasu City, Arizona); and Yuma Regional Medical Center (Yuma,

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Arizona).

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5.

In order to be eligible for Disproportionate Share Hospital (DSH) payments from the

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Department, Plaintiffs must provide all information that the Department considers in

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determining eligibility of California hospitals for DSH payments and allocation of such

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payments. Upon receipt of all the required information for a period upon which DSH

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payments are made, the Department will determine Plaintiffs’ eligibility for DSH

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payments and the allocation of any such payments under the same standards applied to

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California hospitals.

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6.

California hospitals, including the California “rural” floor.

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The Department will apply to Plaintiffs the same wage index adjustments that it applies to

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Plaintiffs may apply to the California Children’s Services (“CCS”) program to have their

policy adjustor. In making this evaluation, CCS shall not apply any state-specific

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For the Northern District of California

eligibility determined for the neo-natal intensive care unit surgery (“NICU-Surgery”)

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United States District Court

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requirements that can only be met by hospitals that are physically located in the State of

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California.

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8.

The Department will use due diligence to implement the provisions of this Order. If the

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Department cannot implement this Order by July 1, 2016, then it shall submit a report to

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this Court explaining why it cannot comply with that deadline and propose a new deadline.

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9.

The Department shall send bi-monthly reports commencing on May 1, 2016, to the

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attorneys for the petitioners and this Court documenting its compliance with the provisions

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of this Order.

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10.

This Court shall retain jurisdiction over this matter for a period of one year from the date

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of this Order for the purposes of determining the attorney fees and costs, if any, owed

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petitioners and resolving any dispute hereunder.

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IT IS SO ORDERED.
Dated: March 24, 2016
______________________________________
EDWARD M. CHEN
United States District Judge

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