18 results for 'cat:"Health Care" AND cat:"Medicaid"'.
J. Milazzo grants a preliminary injunction to a 71-year-old widow with a medical condition and sole custody of her 6-year-old granddaughter. The Louisiana Department of Health is ordered to continue paying the woman’s Medicaid health premium while she challenges the state’s termination of her benefit based on its “size of the family” criteria that does not include children or grandchildren. Louisiana stopped paying the grandmother’s monthly Medicaid premium in early April 2024, based on its conclusion she lived in a one-person home, a finding that does not include the child, who is dependent upon her for financial support. Louisiana’s Medicaid manual limits the state’s family size criteria to a household of two - an applicant and an eligible spouse.
Court: USDC Eastern District of Louisiana , Judge: Milazzo, Filed On: April 30, 2024, Case #: 2:24cv728, NOS: Other Civil Rights - Civil Rights, Categories: Government, health Care, medicaid
J. Hamilton finds that the lower court improperly dismissed the hospital's claim against the state because the private managed care organizations the state contracts with to pay Medicaid bills systematically delayed and reduced payments owed to the hospital for treating patients covered by Medicaid. The hospital has a viable right to have the state ensure timely payments from managed care organizations and this right is enforceable in this section 1983 actions against the state health agency's director. Reversed.
Court: 7th Circuit, Judge: Hamilton, Filed On: April 25, 2024, Case #: 21-2325, Categories: Government, health Care, medicaid
J. Wilkinson finds the lower court properly found the free-choice-of-provider provision of the Medicaid Act creates enforceable individual rights. South Carolina argued a recent high court ruling compels the conclusion that individual Medicaid beneficiaries cannot enforce the free choice-of-provider provision, but the ruling did not change the law to an extent that would call previous determinations into question. Affirmed.
Court: 4th Circuit, Judge: Wilkinson , Filed On: March 5, 2024, Case #: 21-1043, Categories: Government, health Care, medicaid
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J. Ryan finds the lower court erroneously upheld family services' denial of Medicaid benefits to the long-term care resident. The rejection notice failed to include a required denial code that would have provided her with adequate information about why her claim had been refused. Additionally, the resident's assignment of several life insurance policies to a funeral home reduced the amount of resources she could allocate toward daily care at the long-term facility, which qualified her for Medicaid benefits. Reversed.
Court: Ohio Court Of Appeals, Judge: Ryan, Filed On: January 18, 2024, Case #: 2024-Ohio-160, Categories: health Care, Insurance, medicaid
J. Choudhury affirms a magistrate judge’s order compelling the depositions of two New York State public health commissioners in a class action alleging the state’s health department and mental health office fail to provide certain mental health services to Medicaid-eligible children. The judge granted the motion after ruling the commissioners possess unique, firsthand knowledge regarding the claims and that information cannot be obtained through other means. The court finds the ruling without any clear error.
Court: USDC Eastern District of New York, Judge: Choudhury, Filed On: January 11, 2024, Case #: 2:22cv1791, NOS: Other Civil Rights - Civil Rights, Categories: health Care, medicaid, Class Action
J. Thissen reverses the human service commissioner's order requiring the Medicaid vendor to return overpayments. While the failure to maintain health service records does qualify as "abuse" in connection with the provision of medical care to recipients of public assistance under the relevant statute, the human services department failed to explain why its payments to the vendor were improperly paid as a result of that abuse. Reversed.
Court: Minnesota Supreme Court, Judge: Thissen, Filed On: January 10, 2024, Case #: A21-1477, Categories: Administrative Law, health Care, medicaid
J. Wendlandt determines that enforcement of a Tax Equity and Fiscal Responsibility Act lien against a MassHealth member is only allowed if the property encumbered by the lien is sold during the member’s lifetime. However, the three-year statute of repose of the Massachusetts Uniform Probate Code does not retroactively bar MassHealth from recouping medical benefits from a member who died before the probate code became effective.
Court: Massachusetts Supreme Court, Judge: Wendlandt, Filed On: December 13, 2023, Case #: SJC-13439, Categories: Debt Collection, health Care, medicaid
J. Strickland grants the "medically fragile" minors' motion for class certification on their claims against the New Mexico Human Services Department regarding its alleged failure to provide private duty nursing staff, as required under the Medicaid Act. Testimony from health care providers established the requisite number of patients and shortfall of nursing care to satisfy commonality and numerosity requirements, while the differences in care requirements for the class members are not so distinct as to require individualized representation.
Court: USDC New Mexico, Judge: Strickland, Filed On: December 12, 2023, Case #: 1:22cv325, NOS: Other Contract - Contract, Categories: health Care, medicaid, Class Action
J. Connolly partially reverses the district court's grant of summary judgment to the human services department and commissioner in the county-based Medicaid purchasers' suit against them seeking to halt the adoption of a managed-care procurement model in their counties. The department's procurement process violates two of the three purchasers' rights to participate in mediation, but not the third. Reversed in part.
Court: Minnesota Court Of Appeals, Judge: Connolly, Filed On: August 14, 2023, Case #: A22-1643, Categories: Administrative Law, health Care, medicaid
J. Jackson grants, in part, a discovery request by potential class action litigants seeking to represent at-risk and marginalized Louisiana children on claims against the Department of Health. Litigants may conduct limited expert discovery to define the term “intensive behavioral services." A more precise definition would help “put a finer point” on class claims.
Court: USDC Middle District of Louisiana, Judge: Jackson, Filed On: June 15, 2023, Case #: 3:19cv770, NOS: Amer w/Disabilities - Other - Civil Rights, Categories: Government, health Care, medicaid