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Medicaid suit gains status as a class action

  Law Center  -   POSTED: 2008/02/14 16:06

Thousands of Northeast Florida residents just became plaintiffs in a class action lawsuit they know nothing about. The lawsuit, filed last month in federal court in Fort Lauderdale, is alleging that the state unfairly traps people into participating in a pilot program for Medicaid. The program draws from recipients in Duval, Nassau, Baker, Clay and Broward counties. The pilot program shifts Medicaid recipients into privately managed care networks. It was designed to manage rising Medicaid costs, which take up a larger portion of the state budget each year.

The lawsuit asks a judge to order the Florida Agency for Health Care Administration to inform recipients in the program that they can change Medicaid plans every year. It also asks for undisclosed damages for all of the 200,000 participants.

The lawsuit was filed on behalf of three Broward County residents. But it is being expanded to the class action, said Shawn Boehringer, a lawyer with Legal Aid of Broward County. The lawyers haven't yet told Northeast Floridians of their part in the lawsuit. That will come later, he said.

Lawyers for the state have filed a motion to dismiss the lawsuit, claiming health care providers already tell people they can change their plan every year and that the three original plaintiffs lack legal standing to sue because they aren't participants in the pilot program.

According to the lawsuit, federal law lets recipients change plans at any time if they have "good cause," but notices sent to program participants didn't explain that adequately.

The state also failed to provide the required notice letting people know they can change their Medicaid plan, or drop it, once a year, the suit says.

Reaction to the pilot program has been all over the map in Florida. A Georgetown University study surveyed 186 physicians in Duval and Broward counties last year and found doctors unhappy with the program and refusing to participate.

But Jay Millson, executive vice president of the Duval Medical Society, said the reaction to the pilot program has been largely positive.

The Nassau County Commission asked the state to exempt the county from the program, but the state refused.

Nassau County Commissioner Mike Boyle said his constituents didn't see a need for the program because they thought Medicaid was fine before.

Pat Glynn, executive director of First Coast Advantage, which manages the care of about 15,000 people with Medicaid in Duval County, said the reaction to the pilot program has been positive.

"I'm sure there are things we can do better, but for the most part the people seem happy," he said, adding that many of the concerns came from people who weren't yet familiar with how the program works.


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