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Grijalva v. Shalala
No. 93-711 (D. Ariz. Dec. 5, 2000); 152 F.3d 1115 (9th Cir. 1998). ; Clearinghouse Number: 49567
Description
Medicare Beneficiaries Settle Challenge to Adequacy of HMOs’ Notice of Service Denials; Fast-Track Review Process Established
Abstract
The court approved the settlement agreement in this class action
lawsuit in which Medicare + Choice enrollees challenged defendant
Secretary of Health and Human Services’ failure to enforce
due process requirements and monitor health maintenance
organizations’ denials of service to class members. Under the
terms of the agreement, defendant agreed to promulgate a Notice of
Proposed Rulemaking governing notice and appeal procedures for
Medicare + Choice plans’ decisions to terminate coverage for
provider services to enrollees. The agreement applies to skilled
nursing facilities, home health agencies, and outpatient
rehabilitation facilities. Plans must give enrollees four
days’ advance written notice of termination; the notice must
explain reasons for the action and the right to an expedited
appeal. An enrollee who requests an expedited appeal will continue
to receive the service until—whichever is later—the
time designated for termination in the notice or the day after a
negative decision on the expedited appeal. Regardless of whether
the enrollee seeks the expedited appeal, other appeal procedures
will remain available, although without continued coverage. The
agreement also provides that defendant will issue guidance
clarifying that Medicare + Choice plans’ failure in only one
or two instances to comply with the new notice and appeal
procedures may constitute substantial failure for purposes of
imposing sanctions. The Health Care Financing Administration
published the proposed rule on January 24, 2001 (66 Fed. Reg.
7593).
