Judge Restores Lost Medi-Cal Drug Benefits

A Superior Court judge Thursday restored millions of dollars in payments for prescription drugs to Medi-Cal patients who lost the benefits under a 1982 state law.

Attorneys for two Medi-Cal recipients who filed suits in 1982 submitted their requests for two preliminary injunctions on Wednesday to Los Angeles Superior Court Judge John Cole. State officials reviewed the drafts Thursday and returned them to Cole, who signed them, his clerk said.

The law, signed by Gov. Edmund G. Brown Jr. in June, 1982, was intended to save $394 million yearly in an effort to contain soaring costs of the $5-billion Medi-Cal program. It included the annual elimination of $20 million worth of drugs and affected about 2.7 million Californians--almost everyone in the Medi-Cal program.

The revised guidelines prevented recipients from using state money to buy cough and cold remedies, antihistamines and most codeine preparations, among others.

Another change required beneficiaries to obtain permission through their doctors or druggists to have some prescriptions filled. That so-called prior authorization requirement already applied to some drugs, but the legislation greatly expanded the list.

The preliminary injunctions force the state to restore payments for the drugs and to allow beneficiaries to get medications without permission from the state, said Ron Marks, an attorney for one of the plaintiffs.

‘Significant Expenditure’

Deputy Atty. Gen. John Spitler said the state would take the case to the U.S. Supreme Court and seek an immediate stay of the order.

“It’s a significant expenditure,” Spitler said. He estimated that the court order could cost taxpayers as much as $47.1 million annually. Of that sum, Medi-Cal pays about half and the federal government pays the rest, he said.

Marks contested Spitler’s claim.

“It’s our position that this represents a savings,” he said. “If people are given the medications they need, they avoid going to doctors and hospitals. Those treatments would cost the state more in the long run.”

The preliminary injunctions arose from two suits filed in response to the legislation by Los Angeles Medi-Cal recipients. One of the plaintiffs, Anna Jeneski, succeeded in getting a Superior Court order temporarily staying enforcement of the law in September, 1982, but it was dissolved after public hearings were held a few months later, said Deputy Atty. Gen. Louis Verdugo, who handled the case until recently.

Last December, Jeneski’s attorneys won in the 2nd District Court of Appeal, which instructed the Superior Court to reconsider its earlier decision. The state Supreme Court refused last month to consider the case, so the Jeneski case-- and a related case filed a few months after it--came before Cole.