Court says Sacramento County must pay UC Davis Medical Center for services provided to indigent residents

A Sacramento County Superior Court judge ruled on Sept. 26 that Sacramento County must pay UC Davis Medical Center for care provided to eligible indigent county residents.

This is the second major court ruling against the county in a lawsuit filed by the University of California Board of Regents in 2009 challenging the county's failure to pay for mostly emergency medical services provided to patients under the County Medically Indigent Services Program (CMISP).

"We are pleased with this latest outcome and look forward to finally resolving this matter in a responsible way -- one that ensures that indigent residents of Sacramento County receive the services and benefits to which they are entitled," said David Levine, UC Davis Health System counsel. "We provide unique benefits to the greater Sacramento region. However, our ability to deliver these services necessarily depends on clinical revenue, and being denied appropriate compensation by the county threatens our ability to fulfill the distinct and indispensable role we play in our community."

Sacramento County had a longstanding contractual relationship with UC Davis for the care of CMISP-eligible patients. On June 30, 2008, the county terminated that contract and chose to access UC Davis' services, at negotiated rates, through a different contractual arrangement with a third-party administrator, Benefit & Risk Management Services (BRMS). Then, in September 2009, the county adopted a policy to not pay UC Davis for any services (emergency or non-emergency) it provided to CMISP beneficiaries. As a result, UC Davis has been providing emergency services to indigent county residents without any compensation for more than two years.

Judge Lloyd Connelly's Sept. 26 ruling establishes that the county has both contractual and statutory obligations to pay UC Davis for the care it provides to indigent patients, even if there is no contract in place between the county and UC Davis. According to the court: "Absent the County's payment to the providers of emergency services, the indigent county residents are deprived of the relief from medically necessary costs to which they are entitled from the County … and which they themselves cannot afford."

Levine said he believes that the county understands that it owes UC Davis tens of millions of dollars for hospital and professional health-care services provided to CMISP patients since July 1, 2008.

"Our hope has always been to resolve this matter outside of court," said Levine. "We are keenly aware of the county's fiscal crisis and have always been open to negotiating a resolution that ends this litigation. Perhaps now the county will come to the table."

UC Davis Medical Center is a comprehensive academic medical center where clinical practice, teaching and research converge to advance human health. Centers of excellence include the National Cancer Institute-designated UC Davis Cancer Center; the region's only level-I pediatric and adult trauma centers; the UC Davis MIND Institute, devoted to finding treatments and cures for neurodevelopmental disorders; and the UC Davis Children's Hospital. The medical center serves a 33-county, 65,000-square-mile area that stretches north to the Oregon border and east to Nevada. It further extends its reach through the award-winning telemedicine program, which gives remote, medically underserved communities throughout California unprecedented access to specialty and subspecialty care. For more information, visit medicalcenter.ucdavis.edu.