By Ben Solis
Gongwer News Service
Three of Michigan’s 10 prepaid inpatient health plans sued the Department of Health and Human Services recently over what they claim was an attempt to “bully” the plaintiffs to agree to allegedly unreasonable and illegal fiscal year 2024-25 contract provisions.
The lawsuit, Northcare Network Mental Health Care Entity v. Michigan (COC Docket No. 24-000198), filed last week in the Court of Claims, further alleges DHHS threatened that if the plaintiffs did not sign the agreement by October 31, DHHS would terminate its relationship with the entities and cut off vital funding.
Northern Michigan Regional Entity and Region 10 PIHP are also named plaintiffs in the lawsuit. DHHS Director Elizabeth Hertel is a named defendant.
“The plaintiffs each signed the FY25 Contract after modifying the offending provisions, but MDHHS refused to counter-sign,” the complaint said. “(The) defendants are now making good on their threat by withholding Medicaid funds from the plaintiffs to the detriment of the beneficiaries the plaintiffs serve.”
Northcare asks Judge Sima Patel to strike and void three contract provisions related to the funding of their respective Internal Service Fund (ISF) accounts, adherence to a settlement in a separate case regarding directives for Medicaid expenditures, which the plaintiffs say is illegal, and alleged attempts by DHHS to shift the financial burden for managing certified community behavioral health clinics to the plaintiffs without state funding in violation of the Constitution.
“This suit also seeks a declaration that even in the absence of a contract, MDHHS is statutorily obligated to continue providing funding to the plaintiffs,” the lawsuit added. “The defendants recently retaliated against the plaintiffs by stating MDHHS will not provide Medicaid dollars to fund the Substance Use Disorder Health Home (SUDHH) programs in their respective regions. The SUDHH program has absolutely nothing to do with the parties’ dispute. While this shameful negotiation tactic will harm Plaintiffs, who have each expended resources in reliance on the defendants fulfilling their obligation to provide the funding, the most significant harm will come to the citizens eligible to receive SUDHH services.”
The plaintiffs are also seeking a preliminary injunction.
Gongwer News Service
Three of Michigan’s 10 prepaid inpatient health plans sued the Department of Health and Human Services recently over what they claim was an attempt to “bully” the plaintiffs to agree to allegedly unreasonable and illegal fiscal year 2024-25 contract provisions.
The lawsuit, Northcare Network Mental Health Care Entity v. Michigan (COC Docket No. 24-000198), filed last week in the Court of Claims, further alleges DHHS threatened that if the plaintiffs did not sign the agreement by October 31, DHHS would terminate its relationship with the entities and cut off vital funding.
Northern Michigan Regional Entity and Region 10 PIHP are also named plaintiffs in the lawsuit. DHHS Director Elizabeth Hertel is a named defendant.
“The plaintiffs each signed the FY25 Contract after modifying the offending provisions, but MDHHS refused to counter-sign,” the complaint said. “(The) defendants are now making good on their threat by withholding Medicaid funds from the plaintiffs to the detriment of the beneficiaries the plaintiffs serve.”
Northcare asks Judge Sima Patel to strike and void three contract provisions related to the funding of their respective Internal Service Fund (ISF) accounts, adherence to a settlement in a separate case regarding directives for Medicaid expenditures, which the plaintiffs say is illegal, and alleged attempts by DHHS to shift the financial burden for managing certified community behavioral health clinics to the plaintiffs without state funding in violation of the Constitution.
“This suit also seeks a declaration that even in the absence of a contract, MDHHS is statutorily obligated to continue providing funding to the plaintiffs,” the lawsuit added. “The defendants recently retaliated against the plaintiffs by stating MDHHS will not provide Medicaid dollars to fund the Substance Use Disorder Health Home (SUDHH) programs in their respective regions. The SUDHH program has absolutely nothing to do with the parties’ dispute. While this shameful negotiation tactic will harm Plaintiffs, who have each expended resources in reliance on the defendants fulfilling their obligation to provide the funding, the most significant harm will come to the citizens eligible to receive SUDHH services.”
The plaintiffs are also seeking a preliminary injunction.
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