Ambulance services file class-action lawsuit
A class-action lawsuit against seven Medicaid Managed Care Organizations (MCOs) has been filed by 18 ambulance services across Pennsylvania, seeking additional payments for emergency ambulance service provided to beneficiaries of the state’s Medicaid Managed Care program. Filed by the representative ambulance services on behalf of all Pennsylvania ambulance services, the complaint alleges that the Medicaid MCOs failed to make appropriate payment for emergency medical services rendered by ambulance services to the Medicaid Managed Care beneficiaries covered under the various MCO insurance plans.
The named defendants in their capacities as Medicaid MCOs are Gateway, UPMC for You, Unison/Med+, Keystone Mercy, AmeriHealth Mercy, AmeriChoice and Health Partners.
According to Doug Wolfberg and Steve Wirth, two of the attorneys for the plaintiff ambulance services, since the introduction of the Managed Care Organizations into the Medicaid program in Pennsylvania several years ago, the MCOs have improperly paid non-contracted ambulance service providers for emergency ambulance service provided to the beneficiaries covered under the defendant MCO’s Medicaid insurance products.
The complaint was filed in the Court of Common Pleas of Allegheny County on Aug. 10. The suit was filed by the law firms of Page, Wolfberg & Wirth LLC of Mechanicsburg and Sinclair, Kelly, Jackson, Reinhart & Hayden LLC of Canonsburg.