PORTLAND, Maine — A health care consumer group has sued Maine’s Department of Health and Human Services, alleging the department has violated state law by not contracting with a nonprofit to provide assistance to applicants for health programs such as Medicaid.
Consumers for Affordable Health Care, which held the $200,000 state contract for health coverage “ombudsman services” from 1999 until last year, has asked a Kennebec County Superior Court judge to restore its contract or order the department to put such a contract out to bid.
The group said that under its contract it would provide people with information and assistance applying for programs such as the state’s Medicaid program, MaineCare, Maine Rx and prescription assistance through phone help lines and other awareness campaigns.
In early December, a group of lawmakers also said ending the program violated state law.
DHHS spokeswoman Samantha Edwards said she had not seen the complaint Monday morning and could not immediately comment on it.
Earlier in December, the department issued a statement saying that it’s not required to contract for outreach services under the ombudsman contract. The department said that it’s only required to hire an ombudsman for managed care programs, which it does not operate.
The lawsuit argues that it is required to provide those services under federal law, if any federal funds are used.
“The department’s failure to renew its contract with CAHC leaves the department with no means of complying with federal law requiring outreach and informational services to eligible and potentially eligible persons under the MaineCare program,” the lawsuit states. “The department … has taken no effective measures to comply with these federal requirements in the absence of the contracted services.”
CAHC announced the lawsuit in a news release Monday. It said about 6,000 families had called its help line in the past year under the contract that ended in June.
“The department cannot ignore the law,” Kate Clearwater, policy director for CAHC, said in the statement. “It must ensure that Maine people have access to these vital services. Our goal is to ensure that the department lives up to its legal obligations.”