On October 1, 2021, L.A. Care’s payment policy changed as they started denying claims for the professional component of clinical pathology (PCCP) services. This new policy called “Source Clarification Regarding Split Billing” denies payment for PCCP services for Medi-Cal beneficiaries. In the state of California, Medi-Cal allows and pays for PCCP services. On September 1, 2023, the California Society of Pathologists and Dr. Lincoln Luk filed a suit against L.A. Care. This lawsuit looks to have L.A. Care revise their policy and compensate PCCP services for hospital-based pathologists.
Please click here for the link to the lawsuit filed to the Superior Court of the State of California County of Los Angeles Case No.: 23STCV2121.