2 clinics sued over Medicaid refusals

June 14, 2007

Page 8

By David Mendell, Tribune staff reporter

Illinois Atty. Gen. Lisa Madigan on Thursday sued two Champaign County medical facilities, alleging they refused primary care to patients covered by the state's Medicaid program.

The anti-trust lawsuit alleges that Carle Clinic Association, P.C. of Urbana and Christie Clinic, P.C. of Champaign turned away Medicaid-insured patients in an effort to divert those patients to their emergency rooms -- where a higher rate could be charged -- and to speed up payments from the state. The suit, filed in Champaign County Circuit Court, also alleges that the two clinics employ more than 90 percent of the physicians in Champaign County and wanted to keep low-income patients from flooding their facilities.

"This callous decision left many of the 20,000 Medicaid-eligible children and adults in Champaign County at risk by leaving them with fewer choices to obtain quality primary medical care -- if they could access primary medical care at all," Madigan said in a written statement. "Medical clinics, like other businesses, must adhere to the anti-trust laws."

One of the clinics denied the allegations.

"Christie Clinic emphatically denies all allegations of wrongdoing in the attorney general's civil complaint," said Alan Gleghorn, Christie's chief executive. "Christie Clinic did not violate state anti-trust laws and did not enter into any unlawful agreements with any of its competitors."

Gleghorn said Christie clinic treats "more than its share" of Medicaid-eligible individuals and was recently commended by Gov. Rod Blagojevich's office for accepting new patients from All Kids health program.

A Carle representative could not be reached for comment.

For years, the medical community has criticized the state's reimbursement payments to health facilities as being too slow. And the growing number of low-income patients covered by the state's Medicaid health program has been a concern of health facilities throughout the Illinois, even as Blagojevich has sought to expand state-backed health coverage.

But Madigan's lawsuit contends turning away new Medicaid-eligible patients from these clinics diverted people to hospital emergency rooms for routine illnesses, a situation that has exacerbated the rising cost of health care. Emergency room care, the lawsuit notes, costs more than clinical care.

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dmendell@tribune.com