Florida Faces Medicaid Class Action Lawsuit

A judge has cleared the way for a class-action lawsuit alleging that Florida’s Medicaid program has violated federal laws by denying coverage for incontinence supplies for adults with disabilities. U.S. District Judge Marcia Morales Howard issued a 37-page decision granting a request by attorneys for two women and the organization Disability Rights Florida to handle the case as a class action. While it is not clear how many people the case could affect, the decision cited one estimate that at least 480 Medicaid beneficiaries a year turn 21 and lose coverage for incontinence supplies that they received as children. Read more.

Source: CBS Miami, April 10, 2023

ActivStyle Takes Stand Against Low Reimbursement

With IlliniCare Health holding fast to its drastic cuts to reimbursement for incontinence supplies, ActivStyle has taken a hard a line. In November, the provider—the state’s largest provider of the supplies—announced it would no longer participate in the payer’s network, something it had done since 2011, says CEO Gayle Devin. “After fighting the fight, we made the decision that we can’t continue to operate at a loss here,” she said. “We labored long and hard over the decision, but if pulling out will help our cause (so be it).” IlliniCare, a Medicaid managed care payer, announced across-the-board cuts to DME and supplies of up to 50% in September 2017, effective Jan. 1, 2018. Concessions were made for other product categories, but not incontinence, despite evidence that providing the right products for patients saves money, says Devin. Read more.

Source: HME News, January 30, 2019