RAAD AL-SHAIKH, Plaintiff and Appellant, v. STATE DEPARTMENT OF HEALTH CARE SERVICES, Defendant and Respondent.

A147939  Decided: March 27, 2018

This Opinion clarifies a provision of 42 Code of Federal Regulations section 447.10 ultimately settling the question that percentage-based billing contracts are not illegal per se.

This Opinion clarifies 42 Code of Federal Regulations section 447.10 (and, in turn, Welf. & Inst. Code, § 14040.5, subd. (b)). This regulation was misinterpreted by the DHCS’s Chief, the Administrative Law Judge, DHCS’s attorneys, and the Superior Court.  They failed to appreciate the regulation’s meaning from its face, and there was n...