Monitor Mondays

Developing Story: Virginia Governor and MCOs Sued by Behavioral Health Providers

September 30, 2019
Monitor Mondays
Developing Story: Virginia Governor and MCOs Sued by Behavioral Health Providers
Chapters
Monitor Mondays
Developing Story: Virginia Governor and MCOs Sued by Behavioral Health Providers
Sep 30, 2019
Chuck Buck | Ronald Hirsch, MD | Knicole Emanuel, Esq. | David Glaser, Esq. | Ellen Fink-Samnick | John K. Hall, MD, JD
As expected, the Governor of Virginia, Ralph Northam, along with six managed care organizations (MCOs), have been named as defendants in a federal lawsuit filed on Wednesday, claiming that more than a dozen of the state’s Medicaid behavioral and mental healthcare providers had their agreements terminated by the MCOs without cause.
Show Notes

As expected, the Governor of Virginia, Ralph Northam, along with six managed care organizations (MCOs), have been named as defendants in a federal lawsuit filed on Wednesday, claiming that more than a dozen of the state’s Medicaid behavioral and mental healthcare providers had their agreements terminated by the MCOs without cause.

The suit was filed by the Potomac Law Group.

During this edition of Monitor Mondays, healthcare attorney Knicole Emanuel, a partner in the aforementioned law firm and a member of the RACmonitor editorial board, provides an update on the lawsuit as it makes its way through the court system.

Also covered in this edition of Monitor Mondays:

  • SDoH Report: Ellen Fink-Samnick, a nationally recognized expert on the social determinants of health (SdoH), has the latest news on this trending topic that is attracting significant media attention. Ellen will also conduct the Monitor Mondays Listener Survey.

  • Monday Focus: A listener reports that Noridian (Jurisdiction F), rather than providing any diagnosis codes for non-dialysis usage, insists on having five scenarios provided in order to determine if an order meets guidance criteria. Attorney and physician Dr. John Hall weighs in on this topic, which seems to have entangled front desk staff, schedulers, and physicians.

  • Risky Business: Healthcare attorney David Glaser returns to Monitor Mondays with his popular segment, in which he reports on problematic issues facing providers.

  • Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, makes his Monday Rounds with another installment of his popular segment.


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