(Central Square) – Fighting over the language of collective bargaining in Medicaid contracts has sparked a lawsuit against the Pennsylvania Department of Social Services and the hospital system, which has accused it of violating.
As in the Central Square reported earlier, new HealthChoices Medicaid managed care agreements are being developed, which will take effect in August. Contracts are valuable – they have cost $ 65 billion over the past 5 years, and 2.8 million Pennsylvania residents are covered by Medicaid agreements.
However, DHS has added wording to its contracts that prohibits network providers that have been shut down for the past five years – unless the provider has signed a collective agreement that effectively requires all suppliers to work together.
The draft language was supposed to be finalized on April 1, but it remains in draft form and has no plans to change the requirements of the collective agreements, as Central Square reported in the following story.
Now the Pennsylvania Association of Hospitals and Health Systems, a trade association representing 235 hospitals in the Commonwealth, has filed a lawsuit to terminate the language of collective bargaining.
“The language associated with collective agreements that the administration has included in Medicaid-managed care contracts is jeopardizing access to health care for Pennsylvania residents who rely on Medicaid,” said Liam Migdale, HAP’s director of media relations.
The lawsuit alleges that DHS does not have the authority to include the language of collective bargaining in Medicaid contracts and did not follow the proper procedure for language introduction. HAP also argues that the National Labor Relations Act precludes the provisions of collective bargaining agreements and that this provision “is arbitrary and capricious”.
“This vague and overly broad contract language will allow current and future administrations to make arbitrary decisions about which hospitals can seek help from patients covered by Medicaid,” Migdale said. “Hundreds of thousands of patients could face service disruptions if the administration puts this into effect against several hospitals later this summer.”
In addition, an umbrella group of health organizations, calling itself the Coalition of Access to Medicaid PA, sent a letter to Democratic Gov. Tom Wolf and Acting Secretary of the Department of Health Meg Sneed expressing their dislike of the language of collective bargaining.
“We are categorically against this provision and ask to remove it,” the letter reads. “Although your administration is a champion of expanding health coverage, these efforts will be called into question if access to resuscitation is not available to those who need it most.”
State Republicans condemned contract language.
“The Wolff administration has once again taken a one-sided approach, and this will negatively affect access to quality care, especially for those who can least afford it,” said Sen. Christine Phillips-Hill, R.Y. “We will see higher costs – and this is a really nightmarish scenario.”
Phillips Hill stressed the threat of a contractual language for access to health services.
“If you don’t live next to a (managed care organization) that’s united in a union, you as a patient – as a Medicaid patient – are at great risk of accessing care,” she said. “What the administration is doing is putting a barrier between the poorest and most needy people in the Commonwealth and their access to health care.”
The Department of Social Services argued that the language of collective bargaining is crucial to guarantee access, not to restrict access to health services.
“Ensuring patients have accessible and comprehensive access to care is our top priority,” said DHS Director of Communications Ali Fogarty. “For health care patients, access to quality care is a lifeline, and the Department of Social Services is committed to ensuring that those receiving care can receive care in or near their community. We will not allow this to be jeopardized. Managed care organizations provide such access throughout the Commonwealth, and we appreciate the many health professionals who care for these patients on a daily basis. ”
In terms of DHS, the language strengthens network requirements so that Medicaid patients can receive the care they need.
“The language of the shutdown in the draft HealthChoices agreement will ensure uninterrupted access to care,” Fogarty said. “This is very important for our most vulnerable patients, especially in rural areas. While the agreements are still being finalized, DHS is working with the MCO to come up with a solution that guarantees patients uninterrupted access to care. ”