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Maricopa County settles suit over 'legacy' medical claims

PHOENIX -- In a health care related legal case that originally involved billing disputes of $356 million and included tens of thousands of individual claims and dozens of health care providers, Maricopa County recently settled the disputes for $45 million.

After years of litigation, the county and the plaintiffs entered into binding arbitration and this settlement has been agreed to by all parties. The payment to the plaintiffs will not impact county services as money for this lawsuit has been held in reserve.

Under former § ARS 11-291[1], Maricopa County played a role in providing eligibility services for the AHCCCS Program. This system ended in October 2001. Under the system in effect until then, counties were required to pay for emergency health care services if Medicaid eligibility could not be established within two days.

Only individuals who were below 34 percent of the federal poverty level were eligible for the program and the health care providers, mainly hospitals, had to meet several additional statutory requirements in order to qualify their claims for payment by the counties.

Maricopa County did comply with the statute and paid tens of millions of dollars for thousands of claims. Supervisor Andy Kunasek said that, “The county has a responsibility to pay its bills, but we also need to make sure that those bills are accurate.”

In certain cases, Maricopa County believed that a number of claims failed to meet all the statutory requirements for reimbursement by the County. Disputes regarding these standards led to more than nearly 40,000 claims being included in a series of law suits filed against Maricopa County.

Ultimately, an Arizona Court of Appeals decision resolved many of the disputed issues in Maricopa County’s favor. The Court of Appeals’ decision returned the case to the trial court for additional proceedings in Maricopa Superior Court Case Number CV1997-021512. Instead of returning to trial, the parties chose to use binding arbitration as a way to limit litigation expenses.

Supervisor Mary Rose Wilcox stated that, “While this dispute has lasted for many years, no patient was ever denied emergency care.”

The language of this statute has changed over the years and the current version does not include the prior program.

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