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Medical assistance rules challenged in court

St. Paul, Minn. — (AP) - Four people on Minnesota's low-income Medical Assistance program on Monday filed what they intend to be a class-action lawsuit, alleging a 2003 law requiring them to pay co-payments for medication and doctors' visits violates federal Medicaid law.

As part of a budget fix, the state demanded new co-payments for prescription drugs, eyeglasses and doctor and hospital visits. The fees are capped at $20 per month for medications plus $3 per medical visit, but Sue Abderholden of the National Alliance for the Mentally Ill, which joined the lawsuit, said the fees quickly overwhelm people who live in group homes or adult foster care.

"These are clearly people who do not have a discretionary income," she said. "You put people, really, between a rock and a hard place. What do they give up?"

Jeffery Dahl, a plaintiff from St. Cloud who has a disease that has cost him the use of his arms and legs, said he's given up all entertainment spending.

He said all but $94 of his $695 Social Security income pays for his board and care, and the remaining money is to pay for his clothing, personal needs and, since the law went into effect in October, his co-payments.

Every year it seems poor and disabled people lose more of the benefits they've been getting.
- Jeffery Dahl, plaintiff

Unable to pay, he said he has gone into debt and had one pharmacy refuse to serve him. A second has now threatened to do the same.

"Every year it seems poor and disabled people lose more of the benefits they've been getting," he said.

The suit, filed in Ramsey County District Court, alleges the state Department of Human Services violated federal Medicaid law by failing to notify some recipients of both the new payments and their right to avoid the fees if they're unable to pay.

More pointedly, it alleges that a provision of state law that allows medical providers to refuse service to a person who has a co-payment debt, if that's their routine practice, directly violates federal law. In those cases, they can refuse service even if a person says they're unable to pay.

In a written statement, Commissioner Kevin Goodno said the state is in compliance.

"The federal government has approved the copay provisions of our state plan - the formal plan for administering the Medicaid program in Minnesota."

He said he couldn't comment further.

Ralonda Mason, attorney for the group, said she will ask the Ramsey County District Court to grant the lawsuit class-action status. The lawsuit seeks to repeal the co-payments and reimburse people who were wrongly charged.

(Copyright 2004 by The Associated Press. All Rights Reserved.)

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