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September 30, 2014

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Health care:

Silver State Exchange customers ask court for immediate help with state system

Updated Thursday, June 19, 2014 | 5:27 p.m.

A group of Nevadans with urgent medical conditions will ask a Clark County judge to force the state’s health care exchange to provide them insurance coverage immediately, a Las Vegas attorney said at a press conference today.

The 18 plaintiffs enrolled in the Silver State Exchange, paid for health insurance but never received coverage or treatment because of defects with the state’s software, said Matthew Callister, the attorney suing the state. The suit was originally filed in May. The request for immediate help will come in a preliminary injunction announced today.

CJ Bawden, the exchange's spokesman, declined to comment, saying the agency does not comment on pending litigation.

Stephen Immerman, Callister’s law partner, pointed the finger at Gov. Brian Sandoval's office, citing information first disclosed in a Las Vegas Sun story about the role of Sandoval's office in the Silver State Exchange's troubled October launch. “The Sandoval administration is extremely negligent and has been," he said. "People are dying. Not enough is being done.”

Tyler Klimas, Sandoval's spokesman, said the governor's office does not comment on pending litigation. But he did add: "We fully expect, however, that Xerox is working to address these issues."

The lawsuit also asks the court to immediately force Nevada and Xerox, the state’s software contractor, to establish a fund to pay for medical procedures the plaintiffs paid for out of pocket while waiting for insurance coverage.

Callister said the plantiffs had faced an “impenetrable barrier” to get coverage despite having paid for it. The patients suffer from a variety of medical conditions that include cancer, brain aneurysms, anemia and thyroid disorders. They're just the kind of patients the Silver State Exchange and the Affordable Care Act were designed to serve.

“They are a horrible example of what happens when there’s this horrific delay in coverage,” Callister said.

Robert Rolain's wife, Linda, is recovering from brain surgery and receiving hospice care at her Las Vegas home. Rolain doesn’t expect his wife to live beyond this year. Rolain tried to enroll his wife in the exchange in October and he paid a premium in January. But his wife didn’t receive coverage until May.

All the while, Rolain said, a tumor kept growing in his wife’s head.

“This has cost me my wife,” Rolain said.

Tom Liefer, 61, suffers from chronic obstructive pulmonary disease. He said he made two $226 premium payments after enrolling on the exchange. But he later received bills from insurance companies saying he hadn’t paid his premiums

“I thought it was going to work well,” Liefer said. “And then everything stopped. There was pages and pages of paper work and nothings been accomplished.”

In April, Callister filed a separate class action lawsuit accusing the state and Xerox of negligence. Callister said he filed the second case in May because of the “urgent and emergent” needs of some patients.

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