A federal judge faulted the state Medicaid program in a strongly worded order, ruling the program had improperly denied 2,000 out-of-network emergency claims submitted by a nonprofit health care provider that treated indigent children.U.S. District Judge Keith Ellison ruled last week that the state had failed its obligation to reimburse out-of-network services under the Medicaid Act.”Without intervention from the Court, the State will continue to refuse to reimburse Legacy for such services,” he wrote.In May, Ellison found the state had unlawfully handed off in-network reimbursement duties to a managed care organization. The latest ruling came on the second set of arguments by Legacy Health.
Source: Federal judge holds state responsible for Medicaid reimbursements – Houston Chronicle