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Health care organization files lawsuit over drug test reimbursement payments

CHARLESTON, W.Va. — A West Virginia health care organization has filed a lawsuit against state agencies and a managed care organization regarding reimbursement for drug tests.

According to a petition filed this week in Kanawha Circuit Court, Ohio Valley Physicians learned in January that UniCare Health Plan of West Virginia would be ceasing payments for drug tests performed in physician office labs. Oho Valley Physicians, which has its principal base of business in Kanawha County, alleges such action has caused multi-day delays in obtaining screening results.

“They are now requiring lab testing to be done by out-of-state labs and other labs that are located elsewhere with serious delays in getting these results back,” attorney Jess Forbes told MetroNews. “You go from a 24-hour turnaround to days and days.”

Ohio Valley Physicians said it has attempted to resolve the issue with UniCare and copied the West Virginia Department of Health and Human Resources and the state Bureau for Medical Services on correspondences. The lawsuit alleges the agencies “have refused to perform their duties to hold UniCare accountable and rectify their breach of obligations,” and the business had no choice but to name both in the lawsuit.

“My folks want to see this in a position where they can treat effectively, but at the end of the day, they can’t continue forever to provide service without reimbursement,” Forbes said.

A Department of Health and Human Resources spokesperson told MetroNews on Wednesday the agency is unable to comment on pending litigation.

The lawsuit also names Tadd Haynes, president of UniCare Health Plan of West Virginia; Bill Crouch, secretary of the state Department of Health and Human Resources; and Cindy Beane, commissioner for the state Bureau for Medical Services.





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