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HMO pullouts upend Connecticut Medicaid

Wall Street Journal (subscription required), May 13, 2008

A legal-aid lawyer's effort to improve healthcare for poor people has left Connecticut's Medicaid program in turmoil, jeopardizing healthcare for thousands of poor residents. It started in 2004, when a staff attorney at the New Haven Legal Assistance Association filed a request under Connecticut's freedom of information law to get health-maintenance organizations to disclose how often the HMOs' computers rejected pharmacy requests to fill Medicaid enrollees' prescriptions. Three years later, the governor demanded more accountability, and when two companies refused to follow the order the state program stripped all four companies of duties, such as setting provider rates.