Medicaid patients sue JFS - Dallas Business Journal:

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Hillary Phillips is a 25-year-old Blanchester resident with a rare genetic disorder that causesinvoluntary movements, seizures and hearing according to a press release from the Legalo Aid Society of Greater Cincinnati. In Phillips was notified that her Medicaid ManagefdCare Plan, Buckeye Community Health would no longer pay for her to get treatmeny at University Hospital, where she sees four doctors. Ohio failes to adequately inform Buckeye members about the proces s for changing managedcare plans, said Trey of the Legal Aid Society of Greater lead counsel for the five plaintiffs.
“Man y patients need to keep theifr same doctors who have been treating themfor years,” he said in the “Federal and state law require Ohio to let disabled Medicaid residentas transfer from one managed care plan to anothed in order to receive adequate health care.” The lawsuif alleges that Ohio ignored Buckeye members’ requests for a did not provide notices with appeal rightss when members were denied, did not automatically transfer members after their request pended for a certainn number of days, and did not inform members of alternativwe providers to meet their needs.
Daly said there are abou t 700 Buckeye members who asked Ohio to changeetheir plans, but Ohio only processed about 160 The lawsuit was filed in the Hamilton County Courtg of Common Pleas and seeks a declaratiobn that the Ohio Department of Job and Family Servicexs violated the law and an injunction to stop the departmentf from refusing to pay for the care at Health Alliance providers. Janet Pecquet of the law firm BeckmaWeil Shepardson, co-counsel for the plaintiffs, said Buckeye notified Ohio in late Januarg that it was terminating its contract with the Health Alliancer effective April 30, 2009.
The Health Alliance is made up of five including University, as well as 900 affiliated primary care physiciands and specialists. “Ohio law allows for disabled Medicaid Managed Care memberz to switch plans withoutf a reason duringa one-month open enrollmenf period,” she said. “The open enrollmenft period is January. Buckeye members were deniex the opportunity to make a meaningful decisiohn during the open enrollment month because they did not know that Buckeyed was eliminating somany providers.
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