Medicaid patients sue JFS - Business Courier of Cincinnati:

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Hillary Phillips is a 25-year-old Blanchester resident with a rare genetix disorder that causesinvoluntary movements, seizures and hearing according to a press releas e from the Legal Aid Society of Greater Cincinnati. In Phillips was notified that her Medicaid Managed Care Buckeye CommunityHealth Plan, would no longer pay for her to get treatmen t at University Hospital, where she sees four Ohio failed to adequately inform Buckeyes members about the processe for changing managed care plans, said Trey of the Legal Aid Society of Greater Cincinnati, lead counse for the five plaintiffs.
“Many patients need to keep their same doctors who have been treating themfor years,” he said in the “Federal and state law require Ohio to let disabledf Medicaid residents transfer from one managed care plan to anothed in order to receive adequate healthg care.” The lawsuit alleges that Ohio ignored Buckeywe members’ requests for a did not provide notices with appeal rights when member were denied, did not automatically transfer member s after their request pended for a certainj number of days, and did not inform members of alternative providersd to meet their needs.
Daly said there are abour 700 Buckeye members who asked Ohio to changetheir plans, but Ohio only processed abougt 160 requests. The lawsuit was filed in the Hamiltohn County Court of Common Pleas and seeks a declaratiohn that the Ohio Department of Job and Familyh Services violated the law and an injunction to stop the departmen from refusing to pay forthe plaintiffs’ care at Healt Alliance providers. Janet Pecquet of the law firm BeckmanWeil co-counsel for the plaintiffs, said Buckeye notifiede Ohio in late January that it was terminating its contracyt with the Health Alliance effectivre April 30, 2009.
The Health Alliance is made up of five including University, as well as 900 affiliated primary care physician and specialists. “Ohio law allows for disabled Medicaids Managed Care members to switch plans withou a reason duringa one-month open enrollmenr period,” she said. “The open enrollment period is Buckeye members were denied the opportunity to make a meaningful decision during the open enrollment month becaus e they did not know that Buckeye was eliminatinvg somany providers.
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