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Jeyaram & Associates and Parker, Hudson, Rainer & Dobbs File Class Action Law Suit Against the State

Class Action Law Suit Against GeorgiaJeyaram & Associates and Parker, Hudson, Rainer & Dobbs have filed suit against the state for withholding millions of tax funds earmarked for severely disabled individuals.

Family members representing people with severe disabilities and a group of their health care providers today filed a class action law suit against the Georgia Department of Behavioral Health and Developmental Disabilities and the Georgia Department of Community Health for withholding funds that were designated for the care of those individuals contrary to controlling law.

United Cerebral Palsy of Georgia, Inc., Coastal Center for Developmental Services, Inc., Hope Haven of Northeast Georgia and Creative Community Services, Inc. as well as four families representing nearly 12,000 individuals in the State seek the return of hundreds of millions of dollars that should have been used to care for those individuals since 2008.  The exact amount will be determined at trial.

The families filing suit represent clients who depend on vital services from these healthcare providers every single day. These clients are some of the most vulnerable members of our communities.  Their daily lives have been negatively impacted in real and tangible ways, as have those of their families and caregivers.

“My daughter Tammy wants and needs activity.  Sitting in front of a TV set is counterproductive for her,” says Angela Tulloh of Kennesaw.

Marilyn Harvill worries about the ongoing and future care of her son, 53 year old Matt Windham.  “Matt has severe brain damage and needs 24 hour one-on-one care.  I am worried about the services Matt will receive in the future because I wasn’t given any notice of the cuts.”

None of the families affected was notified by the state of the pending cuts and none was given any recourse.

Additionally, an undetermined number of other individuals requiring new services have been turned away due to the improper budget cuts.

Those organizations filing suit are designated Medicaid providers. The two state agencies being sued have failed to reimburse the plaintiffs for services provided under contract to clients with profound intellectual and developmental disabilities. That has led to severe financial harm to these providers. The state has very specific rules and procedures it must follow before reducing already agreed upon payments to providers and families.  None of those procedures has been followed.

These cuts in Medicaid funds were not tied to the recent economic downturn; rather the funds were allocated by the state legislature and simply not paid in full to the providers and clients who depend on them.

“We have gone through our financial resources to keep serving our existing clients, but we have had to turn away other people with severe developmental, medical and behavioral needs.  I don’t know what happens to those people,” says Sally Buchanan, CEO of Creative Community Services of Norcross.

Curt Harrison, Associate Executive Director of United Cerebral Palsy Georgia and South Carolina, says

“So many people rely on us and we’re doing the best we can.  But development of new services and additional employee training have really suffered.  However, we don’t think it’s morally appropriate to cut services.”

 To view this story on Channel 46: http://www.cbsatlanta.com/story/23086886/exclusive-lawsuit-filed-against-state-of-georgia-alleges-funds-withheld-for-disabled

Georgia Senate Approves Hospital Medicaid Financing Program Act

On January 17th, the Georgia Senate passed Senate Bill 24, also known as the Hospital Medicaid Financing Program Act.  The bill passed with a 46-9 vote, and authorizes the Department of Community Health to establish a financial structure to protect Georgia’s healthcare system and obtain additional federal funding for the state’s Medicaid program.

The bill was sponsored by Sen. Charlie Bethel (R – Dalton) who is quoted as saying “A failure to pass SB 24 would mean devastating cuts in reimbursement rates for medical providers. Hospitals could face up to a 32% percent reduction in Medicaid reimbursements, which could also mean a loss of services and jobs. The impact of hospital closures and layoffs as a result of reduced reimbursements on rural communities and local job markets would be devastating.”

Notably, the state’s hospital industry has been supportive. It has been reported that the proposed Act will raise $689 million in state and federal funds to help provide health care to about 100,000 additional low-income and disabled Georgians expected to join the Medicaid rolls as a result of federal health-care reform.

During his State of the State address, Governor Deal warned lawmakers that without the additional revenue, the state would be forced to slash Medicaid reimbursements to hospitals by 20 percent.

Introduced into the Senate on behalf of the governor, the legislation would turn over responsibility for assessing the 1.45-percent tax on adjusted gross patient revenues to the Georgia Department of Community Health (DCH).

The Georgia House of Representatives is expected to take up the bill when lawmakers return to the Capitol Jan. 28 following a week-long recess.

UPDATE 2/2/13: Georgia House of Representatives passed Bill 24, and Governor Deal is expected to sign the bill ensuring $450 million in federal money for the Medicaid insurance program.

Read more: http://www.sfgate.com/news/article/Ga-House-adopts-Medicaid-financing-fix-4242885.php#ixzz2JkwBESwB

U.S. Supreme Court’s Reasoning in Upholding Required Health Insurance Is Questionable

Yesterday the U.S. Supreme Court upheld the Patient Protection and Affordable Care Act.  While some of the media’s “talking heads” may say they were not surprised by the decision few, if any, can say that they were not surprised by the Court’s reasoning in upholding the Act’s most controversial element requiring most Americans to have “minimum essential” health insurance.

The High Court accepted the government’s secondary argument that what the Act calls a “penalty” against Americans that do not obtain the required insurance is valid on a tax since the penalty is to be paid to the IRS and varies based on income.  At first blush is seems like taxes are levied against Americans that make a choice to take an action like purchase a good, own land or live in a particular state, as opposed to choosing not to do something like the purchasing of insurance contemplated in the Act.

Writing for the majority, Chief Justice Roberts framed the tax analysis under the premise that a number of people would opt to pay the penalty rather than pay for health insurance.  The Court repeatedly refers to the penalty as a “payment” rather than a “fine” or “penalty” (as it is referred to in the legislation) to emphasize its point that the penalty is not punitive.  Roberts wrote that “The payment is not so high that there is really no choice but to buy health insurance; the payment is not limited to willful violations, as penalties for unlawful acts often are; and the payment is collected solely by the IRS through the normal means of taxation.”

Chief Justice Roberts went on to explain that “[N]either the Affordable Care Act nor any other law attaches negative legal consequences to not buying health insurance, beyond requiring a payment to the IRS.” He particularly stressed that “Congress’s choice of language…does not require reading §5000A as punishing unlawful conduct. It may also be read as imposing a tax on those who go without insurance.”

We have concerns whether the Court’s characterization of the penalty as a tax will  act as an instruction manual for greater government control over citizens’ inaction simply by characterizing penalties as taxes in any legislation.