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Mission Hospital Regional Medical Center et al v. Toby Douglas

May 25, 2011

MISSION HOSPITAL REGIONAL MEDICAL CENTER ET AL., PLAINTIFFS AND APPELLANTS,
v.
TOBY DOUGLAS, AS DIRECTOR, ETC., DEFENDANT AND APPELLANT. KAISER FOUNDATION HOSPITALS ET AL., PLAINTIFFS AND APPELLANTS,
v.
TOBY DOUGLAS, AS DIRECTOR, ETC., DEFENDANT AND APPELLANT.



(Super. Ct. No. 05-CS-01398) (Super. Ct. No. 06-CS-01279)

The opinion of the court was delivered by: Nicholson, J.

Mission Hosp. Reg. Med. Center v. Douglas

CA3

NOT TO BE PUBLISHED

California Rules of Court, rule 8.1115(a), prohibits courts and parties from citing or relying on opinions not certified for publication or ordered published, except as specified by rule 8.1115(b). This opinion has not been certified for publication or ordered published for purposes of rule 8.1115.

In Mission Hospital Regional Medical Center v. Shewry (2008) 168 Cal.App.4th 460 (Mission Hospital I), this court ordered a writ of mandate be issued to prohibit the state Department of Health Care Services (the Department) from applying a legislatively enacted rate freeze when determining reimbursements owed to plaintiffs for rendering inpatient care to Medi-Cal patients. By the time the writ issued, the Department had mostly completed its reimbursement determinations.

Plaintiffs then sought to enforce the writ by seeking an order compelling the Department to recalculate its reimbursement determinations and reimburse plaintiffs money they would have received had the rate freeze not been applied. The trial court granted plaintiffs' request.

The Department appeals. We conclude the trial court exceeded its authority by ordering relief that exceeds the scope of our order and that was neither pleaded nor proven by the plaintiffs. We reverse on that basis.

FACTS

The underlying action's facts and statutory background are detailed in Mission Hospital I and will not be repeated here. For purposes of this appeal, it is important to understand the following:

Plaintiffs, a group of over 100 California hospitals, filed petitions for writs of traditional mandate in 2005 challenging the Legislature's 2004 enactment of a law that froze rates the state would apply to reimburse plaintiffs for inpatient services they rendered to Medi-Cal patients during the state's 2004-2005 fiscal year. The freeze was contained in section 32 of Senate Bill No. 1103 (2003-2004 Reg. Sess.) (Stats. section 32).

Plaintiffs claimed the Legislature adopted Stats. section 32 in violation of federal Medicaid law and the federal and state Constitutions. In particular, plaintiffs alleged the Legislature adopted the rate freeze without complying with notice and hearing requirements imposed by 42 U.S.C. § 1396a(a)(13)(A) (section (13)(A)), and without making certain substantive findings required by 42 U.S.C. § 1396a(a)(30)(A) (section (30)(A)).

Plaintiffs prayed for a writ of mandate declaring Stats. section 32 violated section (13)(A), section (30)(A), federal regulations, the state Medicaid plan, and the federal and state Constitutions. Plaintiffs also prayed for a writ of mandate to prohibit the Department from implementing Stats. section 32 without first complying with all applicable laws. Except to ask for attorney fees, costs of suit, and any other relief the court deemed proper, plaintiffs did not pray for monetary relief or damages.*fn1

By judgment entered December 19, 2006, approximately eight months after the Department began applying Stats. section 32, the trial court rejected most of plaintiffs' allegations. It concluded plaintiffs were entitled to mandamus relief only in so far as Stats. section 32 applied to services the hospitals rendered ...


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