Medi-Cal Sued For Pushing Patients Into Managed Care Despite Judges’ Orders


Like Medicaid programs in many states that want more budgeting certainty or hope to save some money, Medi-Cal is shifting many patients like Diaz, with complex conditions, into managed care plans.
News Story (California)

Emily Bazar
Kaiser Health News (KHN)
August 10, 2017
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Tags: Health Care, Medicaid

Organizations mentioned/involved: Neighborhood Legal Services of Los Angeles County (NLSLA), Western Center on Law & Poverty (WCLP) (CA)


DETAILS

The lawsuit, filed in Los Angeles Superior Court, alleges that the department is contradicting doctors’ opinions and illegally reversing decisions by administrative law judges that would allow patients with complex medical conditions to remain in fee-for-service Medi-Cal.

“As a result, they’re putting our clients at great medical risk,” said Mona Tawatao, senior attorney for Western Center.

The department said it does not comment on pending litigation.