Assembly Bill (AB) 97 (Statutes 2011) added sections 14105.07, 14105.192 and amended section 14126.033 of the Welfare and Institutions Code (W&I) authorizing the Department of Health Care Services (DHCS) to reduce Medi-Cal provider payments for services that Distinct Part Nursing Facilities-Level B providers render on or after June 1, 2011. On December 28, 2011, the United States District Court (Central District) issued a preliminary injunction in the case of California Hospital Association v. Douglas, establishing the following:

• DHCS is allowed to pay the AB 97 mandated rates only for services rendered June 1, 2011, through December 27, 2011, that are first reimbursed on or after December 28, 2011. 

• DHCS is prohibited from implementing the AB 97 mandated rates for services rendered on or after December 28, 2011.

NOTE: The rates are subject to further litigation developments, including the possibility that the preliminary injunction could be overturned by an appellate court. In that event, DHCS would be authorized to take action as ordered by the court.

In accordance with AB 97 and the December 28, 2011, federal injunction, DHCS will pay the 2011-12 rates as referenced in the chart below.

 2011.12 Reimbursement Rates – DP/NF-B (PDF)