Hawaii Coalition for Health v. State of Hawaii, Department Of

MEMORANDUM

The Hawai’i Department of Human Services (“DHS”) oversees a program known as QUEST Expanded Access, or “QExA,” which is designed to facilitate access to health care services for Medicaid-eligible aged, blind and disabled (“ABD”) populations. Pursuant to a request for proposal (“RFP”) process, DHS contracted with two organizations, Ohana Health Plan, Inc. (“Ohana Health”) and Evercare, to provide these services.

After these contracts were awarded but before QExA had been implemented, plaintiff Hawai’i Coalition for Health (“HCFH”) filed a complaint pursuant to 42 U.S.C. § 1983 against DHS seeking to enjoin the implementation of QExA. The complaint alleged, among other things, that i) DHS would violate 42 U.S.C. § 1396u-2(a)(2)(A) if it followed through on its plan to require special needs children to enroll in QExA, ii) QExA would substantially impair access to services in violation of 42 U.S.C. § 1396u-2(a)(l)(A)(ii), and (iii) DHS violated 42 U.S.C. § 1396u-2(b)(5) and 42 C.F.R. 438.207 when it failed to obtain adequate assurances that the two selected plans had the capacity to provide appropriate services. The district court dismissed the complaint as failing to…