Lawsuit challenging Medicaid decision
By JEFF TESTERMAN
© St. Petersburg Times, published November 3, 2000
Louis F. Ladson Jr. has spent the past 15 years establishing a community pharmacy in Clearwater that has a mostly poor clientele.
Ladson's Lincourt Pharmacy at 501 S Lincoln Ave. delivers prescriptions to Medicaid patients free of charge, offers seminars on public health issues and was one of the first local pharmacies to extend its services to persons afflicted with HIV.
Now, following a sudden administrative action by the state of Florida, the future of the Lincourt Pharmacy is in doubt, and the pharmacy's clients -- 75 percent of whom rely on Medicaid -- may have to find another place to get their medications.
The Florida Agency for Health Care Administration notified Lincourt in a letter received Oct. 10 that it would terminate the pharmacy's Medicaid provider contract in 30 days, according to a lawsuit filed in federal court in Tampa by Ladson and Lincourt late Wednesday.
Ladson claims in his suit that the action is unlawful. He is asking a judge to issue an order halting the state's attempt to cancel the Medicaid contract.
"I'm completely devastated by this," said Ladson, who is a major in the U.S. Army Reserve.
"I'm being treated like I'm guilty before I have any chance to defend myself. That's not supposed to be the way we do things in America."
Ladson's lawsuit echoes a federal suit filed against the state last month by Vencor after the health care agency terminated Medicaid provider agreements for three of the company's nursing homes. The same attorney who handled the Vencor action, Morris "Sandy" Weinberg Jr., is handling the Lincourt Pharmacy suit.
On Oct. 2, the date of the state termination letter to Lincourt, the Agency for Health Care Administration announced during a news conference in Tallahassee that it was terminating six Medicaid contracts of nursing homes with deficient records and ordering the relocation of 628 of the homes' Medicaid patients.
Weinberg filed suit for Vencor on Oct. 5. In a hearing on Oct. 10, U.S. District Judge James D. Whittemore said he doubted the state acted legally when it canceled the Vencor contracts. Whittemore issued a restraining order that stopped the patient relocations and reinstated Medicaid funding. The judge also ordered the state to return and defend its actions.
On Oct. 18, the state and Vencor announced that their differences had been settled, with all Medicaid contracts restored by the state and with heightened care and employee training at its nursing facilities promised by Vencor.
In the Lincourt Pharmacy suit, Weinberg alludes to Whittemore's action rebuffing the state and says it violated the statutory and regulatory framework of the Medicaid program.
The health care agency apparently based its decision to void the Lincourt contract on a May audit of the pharmacy. An auditor alleged problems that included missing hard-copy prescriptions, over-billed quantities, unauthorized refills, missing prescription numbers on hard-copy prescriptions, missing DEA numbers and prescriptions that appeared to be refilled too soon based on daily dosages.
The pharmacy was not supplied a copy of the audit summary and was forced to submit a public-records request to the state on Oct. 26 to try to learn the basis for the Medicaid contract termination, according to the suit.
As in the Vencor case, Lincourt asserts that the state action violates Medicaid regulations and seeks a court order enjoining the state from cutting off Medicaid funds.
Pat Glynn, a spokesman for the health care agency, said the general counsel's office was reviewing the Lincourt lawsuit Thursday and would respond in an appropriate fashion in the future.
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