Judge hears suit accusing state of failing to provide services required by health care law

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NASHVILLE, Tennessee — A federal judge said Friday that he plans to rule as early as next week on a lawsuit accusing the state of failing to provide certain services required by the federal health care law.

U.S. District Judge Todd Campbell heard the lawsuit filed by the Southern Poverty Law Center, the Tennessee Justice Center and the National Health Law Program.

It accuses the state of not providing in-person assistance and forcing applicants to apply for TennCare — the state's expanded Medicaid program — through the federal Health Insurance Marketplace website, which the lawsuit says was not designed for that purpose.

The lawsuit also accuses the state of failing to let people know within 45 days if they're eligible for Medicaid and doesn't provide a hearing if there's a delay in the eligibility decision.

Plaintiffs' attorneys want the judge to issue an injunction that will require the state to "provide timely access to medical assistance, as required by law, and will provide a hearing when there are delays," according to the lawsuit.

One of the main points of contention during Friday's hearing was the question of who is responsible for handling the plaintiffs' applications. Plaintiffs' attorneys said some of their clients have been waiting more than 200 days to see if they're eligible.

Defense lawyers say the burden lies with the federal government; plaintiffs' attorneys say the state is responsible under the new law.

"The one option the state does not have is to throw up their hands and do nothing," said plaintiffs' attorney Christopher Coleman.

Defense attorney Michael Kirk countered with the argument that the federal government shares blame because it has failed to provide the state with certain information about the plaintiffs that would allow state officials to properly handle appeals.

"The state cannot supervise the federal government," said Kirk, who asked the judge to dismiss the lawsuit.

The lawsuit follows a letter from the Centers for Medicare and Medicaid Services that was sent to state officials in June, accusing them of failing to meet requirements of the health care law.

According to the CMS letter dated June 27, Tennessee has met only one of seven critical success factors required of states: the ability to receive and process application files from the health insurance marketplace.

One of the main criticisms has been the state's delay in bringing a $35 million computer system online.

In the letter, CMS deputy director Cindy Mann said her agency had expressed concerns for the past nine months about continued delays and the "downstream impact" on the state's ability to enroll Medicaid-eligible people.

TennCare officials have publicly expressed their concerns about the performance of Northrop Grumman, the company that won the bid to build the computer system.

Kirk said Friday that the state has contracted with another company to audit Northrop Grumman's progress and provide projections for when it will be ready. Meanwhile, he said the state is using the federal website, or healthcare.gov.

Regardless of the mechanism, plaintiff Terri Lynn Casola said she just wants to get health coverage for herself and 3-year-old son. The 25-year-old applied in March and is still waiting. In that time, she's had to go to the emergency room to get treatment for kidney problems because she doesn't have a doctor, and has incurred about $6,000 in debt.

"As a single mom, it's definitely impacted me," she said. "I'm concerned for my health ... and for my son."

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