The University of Maryland Medical System is filing suit against a Medicaid managed care organization for $15 million in denied claims.

The lawsuit alleges that Maryland Physicians Care MCO (MPC) “engaged in longstanding, ongoing, deliberate, and systematic practices of denying timely and complete payment for covered medical services provided to MPC Members by UMMS.”

UMMS alleges that it provided 15,000 lower-income patients who use Medicaid in emergency departments in 11 hospitals across the state.

“Our hospitals serve as critical health care access points for vulnerable populations across Maryland. Payment was denied for essential care that UMMS provided to more than 15,000 people, including premature babies with special needs and patients recovering from heart attacks, gunshot wounds, strokes and other life-threatening conditions,” said Dr. Mohan Suntha, president and CEO of UMMS.

UMMS is asking the court to order the payment of the claims and change its reimbursement practices.

In the suit UMMS states that since MPC joined the network in 2018 that MPC has denied 99% of complex emergency claims and 70% of COVID-related claims.

Maryland Physicians Care is a managed care organization. MCOs are privately run and contract with the state to deliver healthcare to Medicaid recipients.

The organization is owned by other hospital systems including Ascension Saint Agnes and Holy Cross Health.

Maryland Physicians Care is disputing UMMS’s account and says it worked in good faith to resolve issues.