NC Medicaid Provider, “Yes, You Have a Case Against CSC,” and the Top 5 Reasons no Lawsuit is Pending Against CSC

62 days with no Medicaid reimbursements. Would you survive? Would your company survive?

Many providers are not surviving the switch to NCTracks.  Yet what do we hear from DHHS?  “NCTracks is on Track.”

Yesterday, during my lunch hour, I made a mad dash to the mall.  My daughter is starting 3rd grade tomorrow, and she was in dire need of some new jeans.

My phone rang as I was comparing the price of jeans.  Ann (short for anonymous) called.  She wanted to know whether I was bringing a class action lawsuit against CSC, the company that created NCTracks.  This is a common phone call for me.  Today, I received another phone call similar, but from Nanny (another short for anonymous). 

Both Ann and Nanny informed me that they run small, Medicaid provider companies.  Medicaid reimbursements constitute most of both Ann and Nanny’s companies’ income. 

Ann and Nanny have not been paid for Medicaid services rendered since June 20, 2013.  62 days ago.

Both want to pursue legal action.  And Ann and Nanny are not alone.  I have had approximately 25-35 Medicaid providers contact me since July 1, 2013, regarding bringing a lawsuit against CSC.

Do providers, who have not been reimbursed since June 20, 2013, have a legal cause of action against CSC?  I believe, yes.  Providers are entitled to prompt payments of Medicaid reimbursements.  In fact, per federal law, 90% of clean claims must be paid to providers within 30 days.  Obviously, 62 days is well-past 30 days.

My advice to providers who want to bring legal action against CSC?

GO FOR IT!!

BUT, understand what a lawsuit entails.  I have made a list below of the top 5 reasons, I believe, no lawsuit is pending against CSC now.  For those providers wanting to bring legal action, read the items below.  Make a reasoned decision as to whether a lawsuit is feasible for you.

So why is there not a lawsuit pending against CSC?

Here are the top 5 reasons a lawsuit is not pending against CSC:

(Disclaimer: I am neither pro nor con for bringing a lawsuit.  This blog is in no way an attempt to bring a lawsuit.  I am merely trying to inform providers as to what details need to be addressed before ever bringing a lawsuit.  In many cases, for the reasons stated below, a lawsuit is not feasible.  Each provider must make up its own mind as to whether a lawsuit would benefit them).

1. Lawsuits are expensive.

Except for plaintiffs’ lawyers, for the most part, attorneys require a retainer and are paid by the hour. 

A lawsuit against CSC would require:

  • Research for filing the complaint (Which venue is best? What defenses will CSC raise? What causes of action do we assert?
  • Drafting/Filing the Complaint
  • Defending against CSC’s Motion to Dismiss
  • Drafting Written Discovery
  • Taking Depositions (each deposition COULD run $10,000+)
  • Responding to Written Discovery
  • Defending Depositions
  • Hiring Expert Witnesses
  • Depositions of Expert Witnesses
  • Motions to Compel/Defense of
  • Motions for Summary Judgment
  • Defend CSC’s Motions for Summary Judgment
  • Pre-Trial Motions
  • Prepare for Trial
  • And probably much more

2. Lawsuits are the opposite of fast.

If you want an immediate remedy (such as getting paid for work rendered, a civil lawsuit for damages is not the way to go, at least, it should not be sole remedy sought).  An injunction may be the better approach…or taking the time to personally drive to NCTracks…

Think of this: After filing a complaint, the defendant gets 30 days (in state  court) to file a response; however, it is pretty standard for the defendant to request an extension.  Then the defendant gets 60 days to answer the complaint.  Filed concurrently with the defendant’s Answer, most likely, would be a Motion to Dismiss.  A hearing would have to be scheduled for the Motion to Dismiss, plus the legal briefs that would need to filed.  We are talking about 4-5 months before we even get into discovery.  Then written discovery and depositions over the course of 9 month to a year.  If trial is scheduled within the first year and a half, you have to understand that whoever loses will appeal…. You get the point….

3. Damages are….?

Here’s the problem with bringing a lawsuit against CSC. You file a complaint alleging over $10,000 in damages (the minimum amount of damages to meet jurisdictional requirements of Superior Court).  Then 1 day later, CSC pays 100% of your claims.

What are your damages?

It depends.  Have you had to terminate staff? Obtain loans and pay interest?  Close an office? 

Obviously, the above-referenced examples would be damages above and beyond the mere payment.  But if your only damages is nonpayment, you may want to re-think a civil suit for monetary damages.

4. Lawsuits are Time Consuming.

Not only are lawsuits time-consuming for the attorneys, but the plaintiffs also will need to devote time to the litigation.

5. Plaintiffs must be deposed.

If you bring a lawsuit, you have to be deposed.  I have never been deposed, but I have deposed enough people to know that depositions, generally, are not fun for the person deposed.

So there you have it.

“The Top 5 Reasons a Lawsuit is Not Pending Against CSC.”

Do you have a legal cause of action against CSC?  Most likely.  Are you entitled to prompt payments of Medicaid reimbursements?  Yes.

But before filing that lawsuit, remember what a civil lawsuit for monetary damages entails.  Make sure you are prepared! 

If you ARE prepared, GO FOR IT!!!!

About kemanuel

Medicare and Medicaid Regulatory Compliance Litigator

Posted on August 20, 2013, in Computer Sciences Corporation, DHHS, Division of Medical Assistance, Health Care Providers and Services, Injunctions, Lawsuit, Legal Analysis, Legal Remedies for Medicaid Providers, Medicaid, Medicaid Billing, Medicaid Reimbursement, Medicaid Reimbursements, Medicaid Services, NCTrack Glitches, NCTracks, NCTracks Billing Issues, North Carolina, Timely Payments and tagged , , , , , , , , , , , , , , . Bookmark the permalink. 2 Comments.

  1. Obviously, the people hurting for the payments are the smaller providers who cannot afford a lawsuit like this. The larger companies usually don’t notice claims issues until after 90 days (I worked for a large home care provider for 10 years and the 91 day mark is when we blinked.) Now, I am a small PDN homecare provider who cannot get paid or receive any information on when I can get reimbursed for all our PDN Services. We just went over the 60 day mark and still no info. The most frustrating part of it is that the people at NCTracks seem dumb founded about the issue every time I call and request an update. They keep telling me we were not authorized for the services yet I hold an authorization in my hand. The PDN dept. at DHHS acknowledges that over 500 patients are going unpaid but tells us there is nothing they can do, its all in CSC’s hands. They seem frustrated with us calling for updates, yet they are the only ones acknowledging the error. Small PDN companies are being forced to downsize or shut down all together left and right, and guess who benefits – not the patients but the larger organizations licking their chops at the situation. Thanks CSC….

  1. Pingback: NCTracks: The Defective Design Affects ALL NC Medicaid Providers!! | medicaidlaw-nc

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