WTNH News Channel 8 / News / 1999

	State Drops Company Providing Medicaid Coverage (Hartford-WTNH) _ Health maintenance organizations in Connecticut may be faced with some big changes that may not be in their favor. Some state legislators are fighting for the right to sue. And one managed care organization is already getting slapped with a suit. News Channel 8's Jayne Saffer reports. If your HMO denies you coverage you need, some lawmakers and Connecticut residents believe you should be able to sue them. Lisa Samekl, Colchester: "You should be able to sue your HMO. They should be held accountable. After paying out why should they do nothing and leave you out in the cold?" The issue is one that members of the Judiciary Committee will take up this session. Senator Donald Williams introduced an HMO liability bill. He believes it will put patient care ahead of HMO profits. Sen. Donald Williams, (D) Killingly: "What we found is that in recent years HMOs are making the same decisions that affect the quality of healthcare that doctors have traditionally made. "This will provide accountability the right to sue an HMO if they deny care that should have been provided the same standard that there has been between patients and doctors." During the election season, many Democratic and Republican lawmakers came out in favor of the patients bill of rights. The centerpiece of that legislation gives a patient the right to sue their HMO. Recently the federal courts ruled in favor of a Brookfield father who son committed suicide after he says Physicians Health Services refused to pay for his sons hospitalization. But the issue of accountability is now being raised against a managed care organization as well. HealthRight was supposed to provide coverage for 34,000 of the state's medicaid clients and uninsured children. The attorney general says that didn't happen and the state will sue. Richard Blumenthal, Attorney General: "Mental healthcare that was needed and deserved by these children under the contract was denied various excuses and runarounds were given." The Attorney General says in the suit they will attempt to recover millions from HealthRight, which only provides care for those who receive state assistance. HealthRight released this statement today: "We believe we have played a critical role in the state's health care system by providing access to quality care for Medicaid patients and uninsured children. This has always been our first priority and we will continue to do whatever is necessary to serve the people who relied on HealthRight." The state says its contract with HealthRight expires at the end of the month and will not be renewed. Today's News Page. WTNH Home Page. ©1999 WTNH/WTNH-DT A LIN station.

State Drops Company Providing Medicaid Coverage
(Hartford-WTNH) _ Health maintenance organizations in Connecticut may be faced with some big changes that may not be in their favor. Some state legislators are fighting for the right to sue. And one managed care organization is already getting slapped with a suit.
News Channel 8's Jayne Saffer reports.

If your HMO denies you coverage you need, some lawmakers and Connecticut residents believe you should be able to sue them.

Lisa Samekl, Colchester: "You should be able to sue your HMO. They should be held accountable. After paying out why should they do nothing and leave you out in the cold?"

The issue is one that members of the Judiciary Committee will take up this session. Senator Donald Williams introduced an HMO liability bill. He believes it will put patient care ahead of HMO profits.

Sen. Donald Williams, (D) Killingly: "What we found is that in recent years HMOs are making the same decisions that affect the quality of healthcare that doctors have traditionally made.
"This will provide accountability the right to sue an HMO if they deny care that should have been provided the same standard that there has been between patients and doctors."

During the election season, many Democratic and Republican lawmakers came out in favor of the patients bill of rights. The centerpiece of that legislation gives a patient the right to sue their HMO.

Recently the federal courts ruled in favor of a Brookfield father who son committed suicide after he says Physicians Health Services refused to pay for his sons hospitalization.

But the issue of accountability is now being raised against a managed care organization as well. HealthRight was supposed to provide coverage for 34,000 of the state's medicaid clients and uninsured children.

The attorney general says that didn't happen and the state will sue.

Richard Blumenthal, Attorney General: "Mental healthcare that was needed and deserved by these children under the contract was denied various excuses and runarounds were given."

The Attorney General says in the suit they will attempt to recover millions from HealthRight, which only provides care for those who receive state assistance. HealthRight released this statement today:

"We believe we have played a critical role in the state's health care system by providing access to quality care for Medicaid patients and uninsured children. This has always been our first priority and we will continue to do whatever is necessary to serve the people who relied on HealthRight."

The state says its contract with HealthRight expires at the end of the month and will not be renewed.

Today's News Page.

WTNH Home Page.