Legal Issues

Medicaid beneficiaries sue Presbyterian HMO

Published in Health Insurance Law Weekly, August 22nd, 2004

Indigent Medicaid recipients are suing Presbyterian Health Plan over a proposal to change how it pays a behavioral health consortium in southern New Mexico.

The federal court lawsuit alleges the change means lower reimbursement rates that will threaten the survival of some organizations in Rio Grande Behavioral Health Services Inc. Rio Grande Behavioral Health, which serves about 1,300 Presbyterian members, is made up of 10 agencies that provide mental health services in a 19-county area in rural southern New Mexico.

Presbyterian had reimbursed Rio Grande with a set monthly payment for each Medicaid beneficiary. The consortium rejected its offer of a...

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Source: Health Insurance Law Weekly (2004-08-22)

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