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A Los Angeles federal judge has tentatively blocked Medi-Cal reimbursement cuts to doctors and other providers who treat low-income patients.

U.S. District Court Judge Christina A. Snyder ruled today that the state cannot reduce payments by 10 percent to Medi-Cal doctors, dentists, ambulance services and other providers. The tentative decision comes after Snyder previously blocked cuts to hospital-based nursing units and some pharmacists.

Gov. Jerry Brown and state lawmakers included the 10 percent cut in last year's budget as a way to save $623 million. They won approval from the Obama administration in late October.

Plaintiffs such as the California Medical Association and the California Dental Association argued that the Medi-Cal cut would reduce access to patients as more providers opt out of the system. The state already pays among the lowest rates in the nation to those who treat low-income patients.

"Medi-Cal patients are already having a tough time getting access to care," said CMA President James T. Hay in a statement. "The approved cuts are irresponsible and will only put the health of California's most vulnerable population further at risk."

Courts have blocked various state budget cuts before, and Brown has blamed rulings for some of the current deficit problems. In a separate case that will have a major impact on whether courts can block such cuts, the U.S. Supreme Court is expected to decide this year if provider groups can sue over cuts to Medi-Cal or Medicaid programs in other states.

Norman Williams, spokesman for the state Department of Health Care Services, said he could not comment on the litigation. But he stressed that the state satisfied federal officials last year.

"What we can say is that the various rate reductions approved by the federal Centers for Medicare & Medicaid Services are supported by extensive analyses conducted by DHCS," Williams said in an e-mail. "The findings showed that the approved reductions will allow California to continue to meet federal standards requiring an adequate level of access to care for beneficiaries."

Updated to include comment from state Department of Health Care Services spokesman Norman Williams.


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