In Family Health Centers of San Diego v. State Department of Health Care Services, the Supreme Court today concludes that California’s Department of Health Care Services wrongly interpreted federal Medicaid law when it denied government reimbursement for education and outreach costs incurred by “nonprofit health centers that receive funding from the federal government to provide basic health care to underserved populations.”
The court’s unanimous opinion by Justice Leondra Kruger doesn’t require reimbursement in this case, but directs the Department to reevaluate the case under correct legal principles. Interpreting federal statutes, regulations, and an administrative manual, the court adopts “[a] narrower definition of unallowable advertising,” one that makes a “distinction between advertising that educates potential beneficiaries about needed care and advertising designed to generate revenue.” The court says that the pertinent manual “distinguishes between advertising designed to facilitate access to available health care services — an educational goal related to patient care — and advertising designed to encourage use of the provider’s facilities over other facilities offering the same or similar services — a goal aimed at whether that care will generate revenue for the provider.”
The court reverses the Third District Court of Appeal’s unpublished opinion.
Related:
Review granted — see here.
Case briefs — see here.