LC COALITION FOR MEDICAL RIGHTS FOR IMMEDIATE RELEASE -- TO ANNOUNCE RESULT OF COURT HEARING ON FRIDAY ON THE ILCs REQUEST FOR COURT ORDERS TO STOP ILLEGAL AUTO-ENROLLMENT OF 200,000 DISABLED ANGELENOS INTO INADEQUATE MANAGED CARE PLANS. July 10, 2014 Press Conference Friday, July 11, 2014, 3 p.m., at CALIF, 634 S. Spring Street, 2d Floor, Los Angeles. The lawsuit of three Los Angeles ILCs, -- independent living centers who assist persons with disabilities to live independently , -- to obtain court orders to stop the States Medi-Cal program from involuntarily enrolling 456,000 of the most elderly, frailest, disabled population in California, – into managed care plans for all their Medi-Cal and Medicare services, comes to hearing tomorrow, July 11, 2014, at 1:30 p.m., in Sacramento Superior Court. The Los Angeles County Medical Association (LACMA) has joined the suit. At the 3 p.m. press conference, the ILCs will be announcing the results of the court hearing, up or down. The population the ILCs seek to protect are the elderly poor and persons with permanent disabilities, who receive health care services from both Medi-Cal and Medicare, who are called duals. There are 200,000 duals in Los Angeles county alone, who are being involuntarily auto-enrolled into a new joint Medicare/Medi-Cal managed care program called the Coordinated Care Initiative (CCI). If injunction is granted, the ILCs will defend it against the States appeal. If relief is denied, the ILCs will seek immediate relief in the state appeals court, to protect the health care rights guaranteed them by Cal. Welf. & Inst. Code, section 14182.17, which provides that DHCS must deliver a notice to duals which informs them that they may opt out of the CCI program for all Medicare doctor and hospital services, by simply returning the notice form to the State to indicate this choice. The basis of the suit is that the state Medi-Cal agency -- Dept. of Health Care Services (DHCS) - is violating state protective laws, (Cal. Welf.& Inst.Code § 14182.17), which require that duals be able to keep their regular fee-for-service Medicare services, such as doctors and hospitals, outside of any Cal MediConnect plan. This statute requires DHCS to notify duals, 60 days before auto-enrollment into a managed care plan, – in no more than 6th grade reading level, – which plainly state that they may opt out of Cal Medi-Connect for their Medicare services, by simply returning the notice form to indicate their opt out choice. The ILCs charge that the State is victimizing and defrauding duals, contrary to this state law, by auto-enrolling them into inadequate CCI managed care plans, by notices which do not inform them of their opt out right, and provide them no form by which they can opt out of CCI to keep their chosen Medicare doctors, hospitals, and prescribed medicine. Instead of the opt-out form required by state law, to continue with their Medicare providers, they are given a false Choice Form -- (see attached, above), -- which only gives them a choice of managed care plans. This tricky Choice Form is no choice at all, and prevents duals from opting out of the CCI for their Medicare services: all, contrary to the state law which requires they be given an option form which they can simply return in order to opt of CCI for Medicare services. ****************** An endorsed filed copy of the suit, (Civil No. 34-2014-080001884), is attached. (It is the last attachment, on the left). The following are attached to this announcement: - The filed complaint of the suit, (Civil No. 34-2014-080001884, Sacramento Superior Court). - The motion for injunction. - The mis-named Choice Form given to duals, which does not permit them to opt out for Medicare services, but only allows them to choose between CCI managed care plans they dont wish to join. - The background for this CCI program. - Senator Rockefellers letter to Secretary of HHS, demanding this CCI program be stopped, because injurious to duals. The ILCs plaintiffs are: - Communities Actively Living Independent & Free (CALIF) - Westside Center for Independent Living (WCIL) - Southern California Rehabilitation Services, Inc. (SCRS) The Independent Living Center of Southern California, Inc., (ILCSC). is also supporting the state lawsuit, and is considering possible federal litigation in federal court to stop this program, if the state suit is not successful. WHO: The plaintiffs are: - Communities Actively Living Independent & Free Contact: Lillibeth Navarro, Ex. Director, lnavarro@calif-ilc - Westside Center for Independent Living Contacts: Alan Toy, [email protected] Neal Richman, [email protected] - Southern California Rehabilitation Services, Inc. Contact: James Baker, [email protected] - Nancy Becker Kennedy, Medicare and Medi-Cal beneficiary, in Los Angeles Email: nancybk@aol - Blane Beckwith, same, in Berkeley, California Email: blane10@juno NOTE: Independent Living Center for Southern California, Inc., (VanNuys), is supporting the action, and, is considering possible federal litigation, if needed. Contact: Norma Vescovo, Executive Director. [email protected] The Los Angeles County Medical Association (LACMA) joined them as co-plaintiffs to stop the forced auto-enrollment of duals into the untried Cal MediConnect program for their Medicaid and Medicare services. Their counsel: Rockard J. Delgadillo, at rdelgadillo@linerlaw. Delgadillo was formerly City Attorney for Loss Angeles. Co-plaintiff MANUAL PUIG-LLANO, MD., a medical doctor specializing in ophthalmology in Chula Vista, is represented by the law firm, Hooper Lundy Bookman, P.C. (Mark A. Johnson, mjohnson@health-law). I Indeed, as stated by Alan Toy, Executive Director of Westside Independent Living Center: Ironically, we find that this form has been structured to prevent any real choice, and therefore threatens the basic rights of people in our community to choose the health coverage that best fits their needs. Lynn S. Carman, of Medicaid Defense Fund, which filed the state suit for the ILCs, says that the MediConnect program is really a Medi Disconnect program, because the way it is being operated, is to disconnect the most needful from their tried and true fee-for-service specialists, and instead, lock them into managed care where the fewer and cheaper the services provided, the more profit for the managed care plans. Also, plans that were to provide MediConnect services to more than half the 456,000 test population in California, have already either been banned by a federal agency for being a serious threat to the health and safety of duals, or postponed because they became bankrupt or lack the necessary data capability. Thus, - CMS banned the managed care plan in Orange County for constituting a serious threat to the health and safety of duals. - Alameda Countys plan went bankrupt and currently cannot participate. - Santa Clara plans cannot participate for lack of data capability. - Further, CMS has banned auto-enrollment of duals into L.A. Care, in Los Angeles, – the largest municipal public health plan in the country, – for Medicare services, due to a low-performing icon (LPI) based on its Medicare quality scores. (Source: Ibd. at 13). (See also, the background for forced auto-enrollment of duals into managed care, which is in the attached news packet.) Contact person for this media release: Lynn S. Carman, lynnscarman@hotmail
Posted on: Fri, 11 Jul 2014 06:23:30 +0000
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