URBANA – An antitrust lawsuit filed more than a year ago by Illinois Attorney General Lisa Madigan accusing Carle Clinic and Christie Clinic of conspiring to fix state Medicaid prices will continue to trial.
Champaign County Judge Richard Klaus issued a written order Wednesday morning denying most of the clinics' motion to dismiss the lawsuit.
Klaus did dismiss the portion of the lawsuit seeking damages on behalf of the citizens of Illinois, stating the Attorney General lacks statutory authority to assert that claim.
The antitrust suit, filed in June 2007, is based on Madigan's claim that the two clinics set identical policies to turn away needy patients on Medicaid starting in 2003, in an attempt to force the state to raise reimbursements to doctors.
The original lawsuit, accusing Carle and Christie of leaving thousands of Medicaid patients at risk because the two clinics control access to nearly all of the doctors in the area, was dismissed and quickly refiled by the state with more supporting detail.
"The court's decision will allow us to continue our efforts to ensure that the 20,000 Medicaid-eligible children and adults in Champaign County have health care choices and can readily obtain quality primary medical care," Madigan spokesman Scott Mulford said.
Klaus wrote that he found the refiled lawsuit contained a sufficient allegation of a "horizontal" price-fixing agreement – described as an agreement between two competitors at the same level in the market.
However, Klaus also wrote that the proof remains for another day.
"The court remains deeply skeptical about the Attorney General's damages claims," he wrote. "It is difficult, at best, for the court to envision the Attorney General proving that the alleged agreement caused anti-trust injury and damages to the state. The state controls the Medicaid reimbursement system, and it is an understatement to say that the system is under a severe stress which has absolutely nothing to do with Carle and Christie."
Neither clinic was ready to comment on the decision later Wednesday, but both have argued in the past that they continued to serve thousands of existing Medicaid clients after they cut off access to new ones because of poor reimbursements from the state.
The clinics later reopened access to additional children and their parents on Medicaid when the state rolled out its All Kids health insurance program.
Champaign County Health Care Consumers Executive Director Claudia Lennhoff said if the clinics are serving more Medicaid patients, she hasn't seen evidence of it.
"It seems that people are still really struggling with access," she added. "I think if the clinics really want to be open about access for people with Medicaid, we would see them advertising and welcoming people with Medicaid."