Arizona health centers sue Medicaid for unpaid services

Arizona health centers are accusing the state's Medicaid program of not reimbursing them for their full costs of all provided services, according to a Capitol Media Services report in the Arizona Capital Times.

A lawsuit filed in federal court Oct. 28 alleges the Arizona Health Care Cost Containment System has not reimbursed health centers for all care provided by dentists, podiatrists, optometrists and chiropractors to low-income people without insurance coverage, the news service reported.

The health centers involved in the lawsuit are federally qualified health centers, and as such receive money from the Health Resources and Services Administration, an agency of HHS, to provide primary care services in underserved areas.

Attorney Matthew Freedus, who represents the health centers, told Capitol Media Services states are required to pay these facilities, on a per-visit basis, for their "reasonable and related costs" in furnishing these services. The lawsuit contends this includes care provided by dentists, podiatrists, optometrists and chiropractors, in addition to reimbursement for care provided by physicians. 

But, Mr. Freedus said, "The problem here is that Arizona is not recognizing the full extent of what that mandatory set of services includes. They're not recognizing, for example, that includes a whole range of preventive dental services."

The lawsuit seeks reimbursement for full costs.

In response to the lawsuit, the Arizona Health Care Cost Containment System told Becker's Hospital Review: "It is AHCCCS' position that coverage is consistent with the federal definition of physician services and that it is in compliance with federal law."  


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