John B. v. Menke

No. 3-98-0168 (M.D. Tenn. Feb. 25, 1998). ; Clearinghouse Number: 52228

Description

Tennessee’s Medicaid Managed Care Program Must Comply with Early and Periodic Screening, Diagnosis, and Treatment Requirements

Abstract

The court entered a consent decree in this class action challenging the adequacy of children’s health services provided by Tennessee’s Medicaid managed care program. Plaintiffs are more than half a million children who depend on TennCare, the state’s Medicaid program, for essential medical and mental health services. In their complaint plaintiffs alleged that the state Department of Health and state Department of Children’s Services deprived children of Early and Periodic Screening, Diagnosis, and Treatment services in violation of Title XIX of the Social Security Act, 42 U.S.C. §§ 1396 et seq., the terms and conditions of TennCare, and the terms and conditions of risk agreements between TennCare and managed care organizations and behavioral health organizations. Plaintiffs charged defendants with depriving TennCare children in state custody of needed health and mental services in violation of Title XIX of the Social Security Act, Title IV, of the Social Security Act, 42 U.S.C. §§ 620–29a, 670–79, and the due process clause of the U.S. Constitution. Plaintiffs sought declaratory and injunctive relief. Under the consent decree Tennessee must take enumerated steps over five years to bring outreach and screening, diagnosis and treatment, coordination and delivery of services, and reporting in TennCare into compliance with Early and Periodic Screening, Diagnosis, and Treatment requirements as set forth in statute, regulations, and controlling Health Care Financing Administration guidelines.

Additional Information

Attorney Information
Plaintiffs represented by Michele M. Johnson, Gordon Bonnyman, Lenny Croce, Tennessee Justice Center, 203 Second Ave. N, Nashville, TN 37201 (615.255.0331); Jane Perkins, National Health Law Program, 211 North Columbia St., 2d Floor, Chapel Hill, NC 27514 (919.968.6308); Mary Giliberti, Ira Burnim, Bazelon Center for Mental Health Law, 1101 15th St. NW, Suite 1212, Washington, DC 20005 (202.467.5730).
Docket Date
1998-02-25 00:00:00+00:00