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Court rejects pharmacies’ appeal on Medi-Cal rates
San Francisco Chronicle

Managed care health plans that serve low-income patients in California don’t have to consider pharmacies’ costs of obtaining prescription drugs when setting their Medi-Cal reimbursement rates, a state appeals court in San Francisco has ruled.

Federal law requires rates to be high enough to provide “quality care” and “adequate … access” to drugs for patients, but doesn’t require states to take pharmacies’ costs into account when determining how much to reimburse those businesses for the drugs they provide, the First District Court of Appeal said in a ruling made public Monday.

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