CHARLESTON, W.Va. -- Eight community health centers sued West Virginia's Medicaid program in federal court late Wednesday, alleging that Medicaid has illegally paid them less than the cost of care for 10 years, jeopardizing their ability to provide needed care.
"If the situation is not remedied immediately, the very viability of the health centers will be in serious jeopardy," the suit states, "with the ultimate harm to befall the vulnerable populations for whom they care."
"It's a serious thing to think about going to litigation with an agency that is also our partner," said Martha Carter, CEO of FamilyCare HealthCenter, which serves about 24,000 patients in Kanawha, Putnam and Boone counties.
"None of us took this lightly," she said, "but we need to be paid fairly and legally if we are to keep providing quality services."
FamilyCare was underpaid about $384,000 in 2009 alone, she said. "That's a substantial amount for our organization."
The centers are asking the court to order Medicaid to raise their payments to the federally prescribed level. "We believe that, without relief, irreparable harm will occur...," said Louise Reese, CEO of the West Virginia Primary Care Association.
The lawsuit is the latest protest of the state's Medicaid payments. In December, Beckley Appalachian Regional Hospital sued Medicaid for underpayment. In November, the University of Virginia medical center stopped accepting West Virginia Medicaid patients, saying it could not afford to treat them because the state pays less than other states do.
In a Jan. 21 letter to the health centers, state Department of Health and Human Resources said Medicaid's payments are not illegally low. Federal regulators approved the state's plan in 2001, attorney Susan Perry said.
Perry cited a California state court ruling that said dentists are not physicians and therefore adult dental care is not a mandatory Medicaid service.
The number of community health center patients is growing fast, Reese said. The federally funded centers must take all patients, regardless of ability to pay.
One in five West Virginians -- about 373,000 patients -- now get their primary care through the state's 28 community health centers.
About 27.5 percent are insured by Medicaid. "When Medicaid does not pay the cost of care, the centers have to take money from other funds" for people who have no insurance, Reese said.
At least eight of every 10 Medicaid dollars are federal. Federal Medicaid sends the money to the state, which then distributes it.