2011 California Code
Welfare and Institutions Code
DIVISION 9. PUBLIC SOCIAL SERVICES [10000 - 18996]
ARTICLE 5.21. Medi-Cal Hospital Provider Rate Stabilization Act
Section 14167.13

(a) Payment rates for hospital outpatient services, furnished by private hospitals, nondesignated public hospitals, and designated public hospitals before January 1, 2011, exclusive of amounts payable under this article, shall not be reduced below the rates in effect on the effective date of this article.

(b) Rates payable to hospitals for hospital inpatient services furnished before January 1, 2011, under contracts negotiated pursuant to the Selective Provider Contracting Program shall not be reduced below the contract rates in effect on the effective date of this article. This subdivision shall not prohibit changes to the supplemental payments paid to individual hospitals under Sections 14166.12, 14166.17, and 14166.23. The aggregate supplemental payments under Sections 14166.12, 14166.17, and 14166.23 that are not derived from the funding made available under Section 14166.20, or intergovernmental transfers described in paragraph (4) of subdivision (d) of Section 14166.12, and paragraph (4) of subdivision (d) of Section 14166.17, for the 2009 10 and 2010 11 state fiscal years, shall not be less than the aggregate payments under each of these sections during the 2008 09 state fiscal year that are not derived from the funding made available under Section 14166.20, or intergovernmental transfers described in paragraph (4) of subdivision (d) of Section 14166.12, and paragraph (4) of subdivision (d) of Section 14166.17.

(c) Payments to private hospitals and nondesignated public hospitals for hospital inpatient services furnished before January 1, 2011, that are not reimbursed under a contract negotiated pursuant to the Selective Provider Contracting Program, exclusive of amounts payable under this article, shall not be less than the amount of payments that would have been made under the payment methodology in effect on the effective date of this article.

(d) Payments to hospitals under Sections 14166.6, 14166.11, and 14166.16 for the 2009 10 and 2010 11 state fiscal years shall not be less than the payments due under the methodology set forth in those sections in effect on the effective date of this article.

(e) Reimbursement to designated public hospitals, or the governmental units with which they are affiliated, for services furnished before January 1, 2011, pursuant to Sections 14166.4 and 14166.7, shall not be reduced below the level of reimbursement provided for in the applicable methodologies in effect on the effective date of this article.

(f) Payments for subacute services furnished by private hospitals, nondesignated public hospitals, and designated public hospitals before January 1, 2011, exclusive of amounts payable under this article, shall not be reduced below the payments that would be made under rates or methodologies in effect on the effective date of this article.

(g) Solely for purposes of this article, a rate reduction or a change in a rate methodology made on or before the effective date of this article that is enjoined by a court shall be included in the determination of a rate or a rate methodology in effect on the effective date of this article until all appeals or judicial review have been exhausted and the rate reduction or change in rate methodology has been permanently enjoined or otherwise permanently prevented from being implemented.

(Added by Stats. 2009, Ch. 627, Sec. 1. Effective January 1, 2010. Conditionally inoperative as provided in Sections 14167.14 (subd. (c)) and 14167.39 (subd. (a)). Conditionally repealed on December 1, 2010, pursuant to Section 14167.18. Repealed as of January 1, 2013, pursuant to Section 14167.17, if not repealed earlier.)