HMO Pullouts Upend Connecticut Medicaid

NEW HAVEN, Conn. -- What started as a legal-aid lawyer's effort to improve health care for poor people has left Connecticut's Medicaid program in turmoil, jeopardizing health care for thousands of poor residents.

The dispute began in late 2004 when Sheldon Toubman, a staff attorney at the New Haven Legal Assistance Association, filed a request under Connecticut's freedom of information law to get health-maintenance organizations to disclose how often the HMOs' computers rejected pharmacy requests to fill Medicaid enrollees' prescriptions. His request came on the heels of one by Yale assistant clinical professor Kari Hartwig, who sought to get physician ...