Another Lawsuit Threatens California Duals Demonstration
On August 29, the Independent Living Center of Southern California, along with three dual eligible beneficiaries, sued the federal and California governments in the US District Court of the Central District of California, Western Division over the state’s dual eligible demonstration, the Coordinated Care Initiative (CCI). The Plaintiffs are seeking to stop the CCI. The National Council on Medicaid Home Care - a NAHC affiliate - discusses key elements of the lawsuit (the Complaint), below.
CCI Denies Services and Informed Consent
In the Complaint, the Plaintiffs allege that the CCI prevents beneficiaries from receiving treatment during its transition period, “namely, from the time the dual is auto-enrolled into a Participating Plan for all Medicare and Medicaid services, to the time that the dual is able, if at all, to be seen and treated by the primary care physician (PCP) to whom the dual is assigned, and, obtains the medicines or treatment prescribed by the PCP.” The Complaint also alleges that “many” beneficiaries were forced to discontinue their previous treatments, which included prescriptions. The Plaintiffs assert that no other duals demonstration prevents enrollees from using their current physician during the transition period, as does the CCI.