Lawsuit Targets State On Medicaid Reviews

Aug 9, 2019

A potential class-action lawsuit filed this week alleges Florida did not properly determine whether Medicaid beneficiaries could continue qualifying for coverage after initially losing eligibility for the health-care program. 

The lawsuit was filed Wednesday in federal court in Jacksonville against the Florida Department of Children and Families and the state Agency for Health Care Administration.

It names as plaintiffs Clayton Harrell, a former foster child who received Medicaid benefits through an adoption-assistance program, and Austin Trueblood, who has Down syndrome and received Medicaid benefits because he qualified for Supplemental Security Income, or SSI, through the U.S. Social Security Administration.

The lawsuit said circumstances led to the men losing Medicaid eligibility through the adoption-assistance program and the link to SSI. But it alleges the state failed to follow requirements to determine whether the men could continue to receive Medicaid benefits based on other factors, a process known as conducting “ex parte” reviews.

The lawsuit contends that the problem extends to other people losing Medicaid benefits and, as a result, it seeks approval to move forward as a class action.

“Plaintiffs and a proposed class of similarly situated individuals have been harmed by defendants’ systemwide failure to conduct ex parte reviews and to provide sufficient notice of termination of their Medicaid coverage in accordance with federal Medicaid law and the Fourteenth Amendment to the United States Constitution,” the 23-page complaint said, referring to the amendment guaranteeing due process.

Harrell and Trueblood are represented in the case by attorneys for the Florida Health Justice Project, Disability Rights Florida and the National Center for Law and Economic Justice.