Keffeler v. Partnership Healthplan

Opinion

BANKE, J.

I. Introduction

Petitioners own pharmacies in Marin and Yolo Counties and used to be paid by the state on a fee-for-service basis for dispensing prescription drugs to Medicaid beneficiaries. However, in late 2010, the state required Medicaid eligible seniors and persons with disabilities to be enrolled in managed health plans. As a result, in 2011, petitioners became part of Partnership HealthPlan of California’s managed care network of pharmacies. Petitioners claim the rates they are paid by Partnership are so low they are being driven to the brink of insolvency. They contend…