Staff Contact: Jane Drummond or Daniel Landon
On Sept. 24, the Cole County Circuit Court heard arguments on the Missouri Health Plan Association’s motion to dismiss the litigation. The motion was predicated on MHA’s standing to bring the case on behalf of its members. Judge Beetem sustained the motion but granted MHA 20 days to amend its petition to allege instances of irreparable harm to its members. MHA will supplement the amended pleading with affidavits to address the issue.
The Missouri Department of Social Services sought summary judgment on the grounds that it intends to pursue rulemaking to implement the reimbursement changes. MHA submitted discovery to the department to determine if it intended to do so by emergency rule. Responses are due to MHA this week; however, the state recently indicated it may forego rulemaking and instead seek a ruling on the original issue raised by the lawsuit – whether its reimbursement changes may be done through its contracts with the managed care organizations or must be the subject of formal rulemaking.
Dismissal of the action or an adverse decision against MHA would allow the department to proceed with its directed payment methodology by contract amendment, which it would likely do shortly after the ruling. If MHA is successful, the department will be required to go through the formal rulemaking process, which will take six to eight months.