IN THE UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF ILLINOIS EASTERN DIVISION

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Everett Robbins
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1 IN THE UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF ILLINOIS EASTERN DIVISION KERIM and ADVIJE MEMISOVSKI, by their mother THERESA MEMISOVSKI, et al., Plaintiffs, -vs- No. 92 C 1982 BARRY MARAM, et al. Defendants Hon. Joan Humphrey Lefkow MONEIA BEEKS, et al. Plaintiffs, -vs- No. 92 C 4204 PHILIP BRADLEY, et al. Defendant Hon. Joan Humphrey Lefkow EMERGENCY MOTION TO COMPEL PROCESSING OF MEDICAID PAYMENTS TO FAMILY CASE MANAGEMENT PROVIDERS Plaintiffs in these two cases are a certified classes of recipients of benefits and services under the Illinois Medicaid program and certain other programs. On September 3, 2015, this Court ordered the enforcement with respect to the current Illinois budget impasse of consent decrees in the two cases, thereby requiring that defendants continue making Medicaid payments to providers of healthcare services without interruption or delay during the budget impasse. By their attorneys, plaintiffs move that this Court enter an order implementing and enforcing its September 3, 2015 order that requires the defendants to provide all FY16 payments to Family 1

2 Case Management (FCM providers for eligible Medicaid expenses. Those payments are Medicaid payments under the court orders pursuant to an interagency agreement between the defendant Illinois Department of Human Services (DHS, which oversees FCM, and the defendant Illinois Department of Healthcare and Family Services (DHFS, which is the single state agency responsible for Medicaid. In support of this motion, plaintiffs state: 1. The Family Case Management program provides services to pregnant women, children under age 1 and children with high risk medical conditions to help them find a doctor, schedule medical appointments, obtain immunizations, and receive nutrition services among other activities. The FCM program is administered by DHFS as the Illinois State Medicaid Authority under an approved interagency program agreement with DHS. DHS is the administrative agency responsible for the FCM program. See Program Agreement between Illinois Department of Public Aid (predecessor agency to DHFS and the Illinois Department of Human Services, August 16, 2000, attached as Ex. A 2. As described in the agreement, DHS contracts with providers to provide case management activities for Medicaid-eligible pregnant women and children and then submits Medicaid-eligible claims to DHFS for processing to the federal government for Federal Financial Participation under the Medicaid program. 3. Since July 1, 2015, no FY16 payments to FCM providers have been made. This is causing FCM providers great hardship and threatening continued access to these critical services for Medicaid recipients. See Affidavits from FCM Providers in 37 Illinois counties attached as joint Ex. B. 4. FCM providers with unpaid FY16 expenses, as established through the attached affidavits, are suffering extreme financial hardship, staff reductions, and risk of closures. The 2

3 reductions and closures of FCM programs are causing and will cause direct harm to plaintiffs who are not and will not be able to receive the assistance they need to connect to medically necessary services including medical appointments, prenatal care, immunizations, and infant nutrition. 5. The ongoing failure to pay FCM providers, and the resulting inability of FCM providers to continue to provide case management to children under age one and those with special health care needs, impairs access for these young children to pediatric providers and to guaranteed Early and Periodic Screening Diagnosis and Treatment (EPSDT services, including access to well child care and required immunizations to prevent childhood disease, in violation of the Memisovski Consent Decree. See Memisovski Consent Decree Paragraphs 14, 18 attached as Ex. C. These explicit provisions of the Memisovski Consent Decree are an essential part of the enforcement of that decree ordered by this Court in its September 3, 2015 orders. 6. Plaintiffs therefore seek that all payments to FCM providers for FY16 be made as would have been done in the absence of a budget impasse without undue delay. WHEREFORE, plaintiffs move that the Court order defendants to immediately process all FCM payments to FCM providers in the same manner and timing as would be in place without a budget impasse and to pay all overdue payments that were due to have been paid since July 2015 immediately. Dated: February 1, 2016 John Bouman Dan Lesser Stephanie Altman Respectfully Submitted, _s/ Thomas Yates One of Plaintiffs Attorneys 3

4 Sargent Shriver National Center on Poverty Law 50 E. Washington, Suite 500 Chicago, IL ( Chicago, IL Thomas Yates Legal Council for Health Justice 180 N. Michigan, Suite 2110 Chicago, IL ( (phone ( (facsimile David Chizewer Goldberg Kohn 55 East Monroe St., Suite 3300 Chicago, IL Attorneys for Plaintiffs 4

5 IN THE UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF ILLINOIS EASTERN DIVISION KERIM and ADVIJE MEMISOVSKI, by their mother THERESA MEMISOVSKI, et al., Plaintiffs, -vs- No. 92 C 1982 BARRY MARAM, et al. Defendants Hon. Joan Humphrey Lefkow MONEIA BEEKS, et al. Plaintiffs, -vs- No. 92 C 4204 PHILIP BRADLEY, et al. Defendant Hon. Joan Humphrey Lefkow CERTIFICATE OF SERVICE Thomas Yates hereby certifies that he is the attorney representing the plaintiff in this action and that a copy of the attached EMERGENCY MOTION TO COMPEL PROCESSING OF MEDICAID PAYMENTS TO FAMILY CASE MANAGEMENT PROVIDERS was served by electronic filing upon Brent Stratton, Chief Deputy Attorney General, Office of the Illinois Attorney General, on February 1, 2016 _s/ Thomas Yates One of Plaintiffs Attorneys 5

Case: 1:92-cv Document #: 533 Filed: 06/30/17 Page 1 of 10 PageID #:3249

Case: 1:92-cv Document #: 533 Filed: 06/30/17 Page 1 of 10 PageID #:3249 Case: 1:92-cv-01982 Document #: 533 Filed: 06/30/17 Page 1 of 10 PageID #:3249 IN THE UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF ILLINOIS EASTERN DIVISION KERIM and ADVIJE MEMISOVSKI, by