District Court to Hear Concerns Regarding Chartered’s Pull Out of DC’s Medicaid Program

District Court to Hear Concerns Regarding Chartered’s Pull Out of DC’s Medicaid Program

July 15, 2013

WASHINGTON—U.S. District Judge Gladys Kessler will hold a public status conference on Thursday, July 25, 2013 at 10:00 AM in response to Chartered Healthcare’s decision to pull out of the District of Columbia’s Medicaid managed care program. At the conference, the District of Columbia will present its plan to ensure that, despite the fact that Chartered is no longer participating in the District’s program, Medicaid beneficiaries will continue to receive the health care services they are entitled to, uninterrupted.  

Chartered pulled out of the District’s Medicaid market on April 30, 2013, leaving a number of health care providers without payment. Since then, both Chartered and the District have said they will follow through on the payments owed. However, resulting payment delays are affecting some providers’ ability to continue to serve Medicaid patients. In the interim, Amerihealth District of Columbia, another managed care plan, has taken over Chartered’s enrollees to ensure they have access to care. 

In an order issued on July 2, 2013, the Court stated that the public status conference will address “issues caused by Chartered’s failure to reimburse EPSDT providers for services rendered to children in the Plaintiff class.”  

Lawyers for the plaintiff class of children in Salazar v. District of Columbia are concerned that the situation may affect children’s access to care and have raised these issues with the Court. Previous court rulings in the Salazar case require the District to ensure that children promptly receive periodic medical, dental, hearing and vision screening and the services needed to address their health problems. The District has until 12pm Monday, July 22 to submit information to the Court addressing plaintiff’s concerns about access to care. 

The Court holds regular status conferences to monitor the Salazar case. The July 25 status conference will serve as an opportunity to hear the District’s plan to ensure that services are continued and will present an opportunity for providers, advocates and others to raise concerns through plaintiffs’ counsel before a federal court.  

Members of the class, advocates and the public are encouraged to contact plaintiffs’ counsel, Zenia Sanchez Fuentes at 202-204-8484 or zsanchez@tpmlaw.com, to suggest questions for the District of Columbia at the status conference. The public is encouraged to attend. The conference will take place at the U.S. District Courthouse at 333 Constitution Avenue, NW, Washington DC, 20001. 

Counsel in the Salazar case are Terris, Pravlik & Millian, LLP, lead counsel; the National Health Law Program; and Lynn Cunningham. 

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