Lawsuit: LePage administration illegally cut off health care help

Lawsuit: LePage administration illegally cut off health care help

A new lawsuit filed by Consumers for Affordable Health Care (CAHC) against the Maine Department of Health and Human Services (DHHS) alleges that the LePage administration is violating both state and federal law by failing to contract for health care ombudsman services.

The ombudsman services are meant to provide Mainers with information and assistance when they apply for various health coverage programs, including MaineCare, Maine Rx and prescription assistance programs, through outreach, education and helpline assistance. In June, DHHS abruptly eliminated its long-standing contract with CAHC to provide these services.

“Maine families need these services to navigate a complex health system and get needed medical care. Without help, many working families and their children will be hurt,” said Emily Brostek, executive director of CAHC. “This lawsuit aims to ensure that Mainers get the help they need, as required by state and federal law.”

According to CAHC, 6,000 Maine families have called them for assistance in the past year.

According to the lawsuit, Maine state law requires the department to contract with a Maine nonprofit to provide ombudsman services, while federal law requires DHHS to provide outreach and education services. The department has fulfilled these requirements through contracted services with CAHC since 1999.

CAHC argues in its petition that DHHS does not have the capacity or a plan to meet these federal requirements and is blatantly violating the state law and that the department should continue its contract with CAHC until it puts the contract properly out to bid and enters into a similar contract with another qualified Maine nonprofit.

“We hear too often from Maine people who need vital health services for themselves or their kids, but can’t navigate the system,” Brostek said. “They can’t interpret the confusing letters they get from the department. They’re told they don’t qualify for help when they do. Often they can’t even talk to a real person when they call DHHS. Maine families need an ombudsman to answer their questions and help them navigate the system to get health coverage they need.”

In December, in advance of lawsuit, a bipartisan group of legislators stood with CAHC to protest the LePage administration’s actions.

“Maine is violating federal and state law right now,” Republican state Rep. Karen Vachon of Scarborough, who is also a licensed insurance agent, told MPBN. “This violation is not only denying Mainers the support, guidance and advocacy they need in sourcing the right health care based on their income and family situation, it also puts at risk their health and will likely cost taxpayers more money when all is said and done.”

The lawsuit comes on the heels of other complaints that DHHS has taken administrative actions to make it more difficult for eligible Mainers to access public assistance. In December, the state received a warning from the USDA based on Maine’s worst-in-the nation record for delays in food stamp assistance.

Photo: CAHC executive director Emily Brostek speaking at a December press conference.

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