Wednesday, January 24, 2018

Ky. Medicaid enrollees sue against federal officials' approval of Medicaid changes and intent to do likewise in other states

Sixteen Kentucky Medicaid enrollees filed a class-action lawsuit in Washington on Wednesday, claiming that federal officials violated federal law by approving changes to Kentucky Medicaid and declaring their intent to approve similar changes in other states. Nine are seeking them.

The lawsuit alleges that work requirements in the program, to be phased in starting July 1, "sharply deviate from the congressionally established requirements of the Medicaid program and vastly exceed any lawful exercise" of the Department of Health and Human Services' authority to waive Medicaid rules for experiments that advance the goals of the program.

The suit also charges that HHS violated the law by authorizing income-based premiums to be paid by Medicaid enrollees, from $1 a month to 4 percent of their household income; locking people out of the program for failing to meet requirement, including paying premiums and making reports; by requiring cost-sharing for non-emergency use of an emergency room; and eliminating payment for non-emergency medical transportation.

In addition to the work and premium requirements, the suit also says the Kentucky plan violates federal law by eliminating of three months' retroactive coverage for disqualified enrollees who re-enroll. The suit says the plaintiffs will be unable to meet the plan's administrative requirements, and "Continuous and adequate health insurance coverage is fundamental for each plaintiff’s ability to work." It describes each plaintiff's situation in detail, taking up 30 pages of the 79-page complaint. For more from Kentucky Health News, click here.

No comments: