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Pharmacy Choice - Pharmaceutical News - ACLU settles with R.I. over improper removal of participants from state-run Medicaid program [The Providence Journal, R.I.] - March 23, 2019

Pharmacy News Article

 1/10/19 - ACLU settles with R.I. over improper removal of participants from state-run Medicaid program [The Providence Journal, R.I.]

Jan. 10PROVIDENCE The ACLU of Rhode Island has reached a settlement with the state over the alleged improper removal of low-income Rhode Islanders from the state-run Medicaid program as a result of glitches blamed on the state's problem-plagued public-benefits computer system known as UHIP.

The settlement sprang out of the federal class-action lawsuit the ACLU filed last year against the state's then-Health & Human Services Secretary Eric Beane, in which it alleged that participants in a Medicaid program run by the state were not being given proper notice before being kicked off the program, leading to a loss of income that the suit says put low-income residents "at risk of losing their homes and their utilities and ... funds needed for their daily living expenses, including food."

According to the ACLU, the lawsuit tied the improper notice to "the state's infamous UHIP computer system system," the subject of another pending ACLU suit regarding food stamp benefit delays.

The state's contract with Deloitte to deliver and run the balky system expires at the end of March, but in a related development Thursday, a Raimondo administration spokeswoman told The Journal: " We are currently contemplating a short-term extension to the contract that will allow us to further evaluate our long-term options. ... We hope to have more information available in the coming weeks."

This lawsuit, filed in U.S. District Court by ACLU of RI volunteer attorney Ellen Saideman, centered on the Medicare Premium Payment program (MPP) that serves individuals who are elderly or have disabilities and are eligible to receive Medicare benefits. In these cases, Medicaid pays the costs for these individuals to participate in Medicare, including their monthly premium for Medicare Part B, "which may be as much as $134, out of their Social Security benefits," the lawsuit said.

"The program thus provides significant financial assistance to those who qualify, and caused substantial hardship to those who were unfairly terminated," the ACLU said Thursday.

At the time the lawsuit was filed a year ago, ACLU of Rhode Island executive director Steven Brown said: "State officials keep on talking about how hard they are working to fix UHIP. Nobody should find that response acceptable anymore. It's been 15 long months for many of the state's poorest residents, so our response is: you clearly aren't working hard enough."

Within a month after the lawsuit was filed, the state added hundreds of individuals back to the MPP program and took steps to ensure that people would not be terminated without notice, the ACLU said in a statement Thursday. "The settlement agreement ensures a process is in place to protect against any slippage in providing proper notice. In settling the lawsuit, the state did not admit to any liability."

"The people participating in the MPP program are among our state's most vulnerable residents. We are pleased that our legal action has established some safeguards against the erroneous loss of this important benefit," Brown said Thursday.

Under the settlement agreement, the ACLU said:

The state agreed to provide "timely and adequate advance notice prior to terminating MPP benefits," and to provide someone who believes he or she has been improperly dropped from the program the right to a hearing to contest an intended termination of benefits.

"In addition, for the next 18 months, the state has five business days to respond to complaints brought to their attention by the ACLU about people allegedly terminated from the MPP without proper notice. The suit also provides a mechanism for the ACLU to seek court action in the event that 'systematic breaches' of the agreement become known."

The state also agreed to pay $59,624.75 in attorneys' fees and costs, according to the ACLU.

The $647.7-million UHIP system short for the Unified Health Infrastructure Project was supposed to streamline state-run benefits programs in Rhode Island, including Medicaid and SNAP benefits for food. But it was launched in September 2016 amid warnings it was not ready for prime time, and it led to major failures and the appointment of a special master to oversee the fix.

The Raimondo administration opted to extend until March 2019 the contract of the company Deloitte that had designed and installed the troubled UHIP system without a backup.

Gov. Gina Raimondo told reporters last March that Deloitte could reapply for the contract, but, "I cannot imagine a scenario in which they could prove to us that they should continue our business."

This was the Raimondo adminstration spokeswoman Alisha Pina's response to the ACLU's announcement of the settlement: "The Executive Office of Health and Human Services is committed to ensuring the RI Bridges system" known more familiarly as UHIP "works for all of our customers and meets federal regulations. We've taken action, ensuring all MPP notices are issued in a timely manner."

Of the expiring Deloitte contract, she said the administration has not yet issued an "RFP" which stands for requests for proposals for a new operator. She did not elaborate.


(c)2019 The Providence Journal (Providence, R.I.)

Visit The Providence Journal (Providence, R.I.) at

Distributed by Tribune Content Agency, LLC.

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