Byline: Michael Perrault News Staff Writer
Rocky Mountain HMO is asking the U.S. District Court in Denver to prohibit the Colorado Department of Health Care Policy and Financing from entering into managed-care contracts for Medicaid services during fiscal year 2001.
In a lawsuit filed Wednesday, Rocky Mountain HMO contends that the state's rate contract for the current fiscal year doesn't meet statutory requirements. Rocky Mountain HMO alleges that the department's actions violated the Actuarial Soundness Statute and state law that requires the department to adhere to federal law to obtain federal funding for the Medicaid program.
Rocky Mountain HMO's motion for a temporary restraining order and preliminary injunction was made on the heels of a lawsuit and judgment earlier this year that required the state to pay $18 million to the HMO. As a result of the judgment, the department revised its Medicaid contracts by removing certain provisions.
Rocky Mountain HMO said it is seeking the injunction because the department imposed a deadline of Monday for managed-care companies to enter into fiscal year 2001 contracts.
``Despite repeated requests from Rocky Mountain HMO and Health Care Financing Administration, the Department has refused to modify the fiscal year 2001 contract to comply with the Actuarial Soundness Statute,'' Rocky Mountain HMO officials said in the complaint. The health maintenance organization also contends that the department refused to extend the contract deadline to allow enough time to resolve the dispute.
Earlier this month, Kaiser Foundation Health Plan of Colorado sued the state to recover alleged underpayments to the plan's Medicaid HMO.
