Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-cand-3_14-cv-03226/USCOURTS-cand-3_14-cv-03226-5/pdf.json

Nature of Suit Code: 450
Nature of Suit: Interstate Commerce
Cause of Action: 28:1331 Fed. Question: Interstate Commerce Act

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United States District Court 

For the Northern District of California 

UNITED STATES DISTRICT COURT 

NORTHERN DISTRICT OF CALIFORNIA 

ASANTE, et al., 

Plaintiffs, 

v. 

CALIFORNIA DEPARTMENT OF 

HEALTH CARE SERVICES, et al., 

Defendants. 

Case No. 14-cv-03226-EMC 

ORDER RE OUTSTANDING 

PROVISIONS 

Pursuant to the Court’s ruling at the hearing of March 10, 2016, and to the parties’ 

stipulation and the Court’s resolution of disputes regarding this Order. 

1. The Department shall apply the terms of this Order to all inpatient Medi-Cal services 

provided by the petitioners as of the date December 21, 2015, unless and until there is a 

further order from the Court amending monetary relief retrospectively. 

2. All of the Plaintiffs in this action shall be deemed to be “border hospitals” as that term is 

defined is State Plan Amendment 15-020. 

3. In its APR-DRG outlier calculations, the Department shall apply to the Plaintiffs the costto-charge (“CCR”) ratio calculation set forth in SPA 15-020. 

4. For purposes of APR-DRG reimbursement the following four hospitals shall be deemed to 

be “remote rural border hospitals” and shall be entitled to the higher APR-DRG base rates 

paid California “remote rural” hospitals: Sky Lakes Medical Center (Klamath Falls, 

Oregon); Asante Three Rivers Medical Center (Grant Pass, Oregon); Havasu Regional 

Medical Center (Lake Havasu City, Arizona); and Yuma Regional Medical Center (Yuma, 

Arizona). 

5. In order to be eligible for Disproportionate Share Hospital (DSH) payments from the 

Case 3:14-cv-03226-EMC Document 81 Filed 03/24/16 Page 1 of 2
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United States District Court 

For the Northern District of California 

Department, Plaintiffs must provide all information that the Department considers in 

determining eligibility of California hospitals for DSH payments and allocation of such 

payments. Upon receipt of all the required information for a period upon which DSH 

payments are made, the Department will determine Plaintiffs’ eligibility for DSH 

payments and the allocation of any such payments under the same standards applied to 

California hospitals. 

6. The Department will apply to Plaintiffs the same wage index adjustments that it applies to 

California hospitals, including the California “rural” floor. 

7. Plaintiffs may apply to the California Children’s Services (“CCS”) program to have their 

eligibility determined for the neo-natal intensive care unit surgery (“NICU-Surgery”) 

policy adjustor. In making this evaluation, CCS shall not apply any state-specific 

requirements that can only be met by hospitals that are physically located in the State of 

California. 

8. The Department will use due diligence to implement the provisions of this Order. If the 

Department cannot implement this Order by July 1, 2016, then it shall submit a report to 

this Court explaining why it cannot comply with that deadline and propose a new deadline. 

9. The Department shall send bi-monthly reports commencing on May 1, 2016, to the 

attorneys for the petitioners and this Court documenting its compliance with the provisions 

of this Order. 

10. This Court shall retain jurisdiction over this matter for a period of one year from the date 

of this Order for the purposes of determining the attorney fees and costs, if any, owed 

petitioners and resolving any dispute hereunder. 

IT IS SO ORDERED. 

Dated: March 24, 2016 

______________________________________ 

EDWARD M. CHEN 

United States District Judge 

Case 3:14-cv-03226-EMC Document 81 Filed 03/24/16 Page 2 of 2