Civil rights groups file complaint over DC Medicaid dispute

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Advocates are framing MedStar’s tactics as a health equity issue.



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Advocates for D.C.’s Medicaid recipients have filed a complaint with the U.S. Department of Health and Human Services over threatened changes to the D.C. Medicaid program.

The groups, including the D.C. branch of the NAACP and the Health Alliance Network, a community organization devoted to health equity, have written to the HHS Office for Civil Rights, complaining that the health of the city’s Medicaid recipients is imperiled by MedStar Health’s dispute with the District government over its Medicaid contract.

The groups pointed to an Aug. 20 letter penned by the D.C. Department of Health Care Finance to the D.C. Council Committee on Health, which said that MedStar Health intends to terminate its contracts with AmeriHealth Caritas DC and CareFirst Blue Cross Blue Shield, two Medicaid managed health care programs operating in the District.

MedStar, which operates two of the city’s largest hospitals, MedStar Washington Hospital Center and MedStar Georgetown University Hospital, has been in a long-standing dispute with the D.C. government over the Medicaid managed care contract of its subsidiary, MedStar Family Choice.

The D.C. Contract Appeals Board ruled last December against MedStar Family Choice’s Medicaid contract with the city. Mayor Muriel Bowser issued an emergency order this month extending that contract and the other two, despite the CAB ruling. But with contracts set to expire at the end of the month, the D.C. Council passed a resolution disapproving of the mayor’s emergency order extending the contracts.

The civil rights and advocacy groups speaking out against MedStar’s threat to end Medicaid contracts with the two insurance companies that provide Medicaid health coverage to the city’s poor.

“MedStar’s actions jeopardize the lives, the health and the safety of over 200 thousand vulnerable DC residents on Medicaid, A majority of whom are “Black and Brown people,” said NAACP D.C. branch president Ali Akosua.

The D.C. Department of Health Care Finance said the action would threaten access to care for as many as 230,000 District residents.

“MedStar Health is using its market share leverage to bully the District into contract renegotiations and threatened to raise the discount pricing they have made to other managed care organizations, jeopardizing the health, well-being and health services access for hundreds of thousands of Black and Brown residents,” said Ambrose Lane, chairman of the Health Alliance Network.

In a statement to WTOP, spokeswoman Marianne Worley said MedStar Health has an unwavering history of caring for all patients in D.C. and its intent has never been to cancel contracts and leave the District’s most vulnerable residents without care.

“MedStar Health’s notifications to the other two Managed Care Organizations (MCOs) in the Medicaid Managed Care program were intended to prompt renegotiation of the existing provider agreements,” Worley said. “Such notices are a routine way to initiate negotiations and occur across our industry as a normal part of how healthcare is delivered and financed.”

With the mayor and the D.C. Council at odds over the Medicaid contracts, the D.C. Department of Health Care Finance warned that if the current contracts between the health plans and MedStar expire Sept. 30, D.C. Medicaid patients will be left without access to MedStar hospitals, clinics, rehabilitation facilities and a network of physicians.


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