Can a state agency set lower Medicaid reimbursement rates for out-of-state hospitals without discriminating against interstate commerce? The Ninth Circuit answered that question “yes” in Asante v. California Department of Health Care Services, ___ F.3d ___, 2018 WL 1570659 (April 2, 2018). In Asante, Ninth Circuit considered a program, Medi-Cal, administered by the California Department of Health Services. Under this program, the Department issued regulations setting lower Medicaid reimbursement rates for out-of-state hospitals than for in-state hospitals providing equivalent services to California residents. (Read more).