Federal Court Orders Disclosure of Medicaid Managed Care Treatment Guidelines: M

Civil Action No. 93-452 (GK)

OSCAR SALAZAR, et al., Plaintiffs,

DISTRICT OF COLUMBIA, et al., Defendants.


Upon consideration of the Motion of Non-Parties HSCSN and MHS (?Non-Parties?) to Reconsider the Court?s Order Granting Plaintiff?s [sic] Motion to Compel and for Stay Pending Reconsideration, and the Motion for Protective Order of those same Non-Parties, the Oppositions, the Replies, and the lengthy history of this case, the Court concludes that the Motion for Reconsideration is granted in part and denied in part, and the Motion for Protective Order is granted in part and denied in part. 
Plaintiffs and Non-Parties have been battling over the discoveryissue raised in these Motions for a long period of time. By now, the issue has narrowed down to whether a Protective Order should be granted to Non-Parties and, if so, how restrictive it should be.1
On December 19, 2006, the Court granted in part and denied in part Plaintiffs? Motion for Leave to Conduct Limited Discovery Concerning Compliance with Paragraph 36 of the Settlement Order [Dkt. No. 1256]. Specifically, Plaintiffs were allowed to obtain discovery of ?the general polices and procedures? of the Non-Parties for authorizing, re-authorizing, and terminating certain health services. On February 6, 2009, the Court granted Plaintiffs? Motion to Compel Specific Discovery Concerning Compliance with Paragraph 36 of the Settlement Order as it Pertains to the Provision of Home Health Care, Private DutyNursing, and Personal Care Services [Dkt. No. 1430].  Specifically, Plaintiffs were granted access to the InterQual® Clinical Decision Support Criteria (?InterQual® Criteria?), which are evidence-based treatment guidelines developed and copyrighted byMHS. Shortlythereafter, Non-Parties filed the two Motions which arenow under consideration.
Non-Parties areseekingreconsideration of the Order of February6, 2009, grantingPlaintiffs? Motion to Compel Production of the InterQual® Criteria and a Staypending such reconsideration, as well as a Protective Order. Plaintiffs oppose those Motions on both procedural and substantive grounds. The Court will now address, albeit briefly, the main issues raised by the Non-Parties and Plaintiffs.2

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