Medicaid patients sue JFS - Dallas Business Journal:

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Hillary Phillips is a 25-year-old Blanchester resident with a rare geneticf disorder that causes involuntary seizures and hearing according to a press release from the Legal Aid Society ofGreater Cincinnati. In March, Phillips was notified that her Medicaix ManagedCare Plan, Buckeye Community Health Plan, woulx no longer pay for her to get treatmenr at University Hospital, where she sees four doctors. Ohio failecd to adequately inform Buckeye members about the process for changinv managedcare plans, said Trey Daly, of the Legapl Aid Society of Greater lead counsel for the five plaintiffs.
“Many patients need to keep theid same doctors who have been treating themfor years,” he said in the “Federal and state law require Ohio to let disabled Medicaid residents transfer from one managed care plan to anotherf in order to receivse adequate health care.” The lawsuit alleges that Ohio ignore d Buckeye members’ requests for a did not provide notices with appeal rightsa when members were denied, did not automatically transfert members after their request pended for a certain numberf of days, and did not inforj members of alternative providers to meet their Daly said there are about 700 Buckeyde members who asked Ohio to changs their plans, but Ohio only processed about 160 requests.
The lawsui was filed in the Hamiltonj County Court of Common Pleas and seeks a declaratio n that the Ohio Department of Job and Familyy Services violated the law and an injunction to stop the departmenf from refusing to pay for the care at Health Alliance Janet Pecquet of the law firm BeckmanmWeil Shepardson, co-counsel for the plaintiffs, said Buckeye notified Ohio in late January that it was terminatintg its contract with the Health Alliancde effective April 30, 2009. The Health Allianc is made up of five including University, as well as 900 affiliated primary care physiciansz and specialists.
“Ohio law allows for disablerd Medicaid Managed Care members to switch plans without a reasonj duringa one-month open enrollment period,” she “The open enrollment period is January. Buckey e members were denied the opportunity to make a meaningful decisiobn during the open enrollment month because they did not know that Buckeye was eliminating somany providers.”