Court Cases « Medicaid: « Benefits – Public

Patricia E. Kefalas Dudek & Associates Court Cases re: Medicaid

• David v. Goliath: One Client's Fight for Attorney Fees and Costs (background article)
  Medicaid Appeal: (attorney fees and costs case – 2009)
  The need to enforce the Constitutional protections of due process is necessary in an effort to level the legal battleground for our clients that rely upon public benefits. The system is difficult to navigate and becomes even more of a struggle when the rules are ignored by the administrative agencies. Consider the unlimited legal representation and resources agencies have at their beck and call, versus the limited resources of a beneficiary on needs-based benefits. It is a very real time David v. Goliath situation.
• John Sullivan Update (December 2008)
  I represented John Sullivan in an appeal seeking more state funding for Mr. Sullivan. For more info on this case, see Medicaid Does Not Have to Find In-Home Services, Judge Rules and Ruling Won't Force In-Home Medicaid.
• Petitioner's Brief for Judicial Review (redacted) (PEKD & Assoc.)
  A Michigan Circuit Court brief regarding a client's request to use Medicaid-funded self determination benefits to facilitate his move to another state.
• Washington v. Debeaugrine (US District Court – Florida)
  This case presents this issue: when a state official erroneously denies a Medicaid beneficiary his or her federal constitutional, statutory, and regulatory right to a hearing before the termination or reduction of benefits, must the beneficiary seek relief only in a state court, or may the beneficiary instead seek relief in a federal district court?
  Patti's Comment: Important Medicaid waiver case which all advocates for folks who are on Medicaid or getting special education services should read!

Patti's Publications re: Medicaid

• Applications and the Appeals Process
• Attachment 1: Advocacy tips for Responding to The Deficit Reduction Act of 2005
  Attachment 2: Single Points of Entry
  Attachment 3: Ask Your Legislator to Vote
  Attachment 4: Sample Cover Letter
  Attachment 5: Frequently Asked Questions
  Attachment 6: OCR Fact Sheet
  Attachment 7: Discrimination Complaint
  Attachment 8: Complaint and Jury Demand
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• Medicaid Outside the Context of Long Term Care, Including Special Needs Trusts
• Attachments 1-3
  Attachments 4-8

Issues

• Home and Community Services Copayment Equity Act of 2009
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• Patti's letter to Senators in Support of HCSCE (3/9/09)
  …"The Act will exempt dually eligible individuals living in home and community settings from prescription drug co-payments. Currently, under Medicare Part D, only individuals living in skilled nursing homes are exempt from prescription drug co-payments. This change is necessary, as assisted living is one of the fastest growing long-term care options for the elderly and disabled." 

  More Info:

  ALFA Commends Senator Bill Nelson's Commitment to Co-pay Equity for Home and Community Based Seniors (MedicalNewsToday – 3/6/09)

Misc. Legal Info and Court Cases

• Employees Providing Support Services to Medicaid Waiver Recipients are not Exempt from Federal Overtime Requirements
  A U.S. district court rules that a company that provided support services to Medicaid waiver program recipients should have paid its employees overtime because the employees did not fall within the "companionship exception" to the Fair Labor Standards Act. Solis v. Firstcall Staffing Solutions, Inc. (W.D. Mo., No 08-0174-CV-W-ODS, Nov. 18, 2009).
• Medicaid Law: An Overview (Cornell University Law School)
• Medicaid Suit Could Determine Who Decides Care: Doctor or State (Law.com – 3/25/09)
  Federal appeals court hears arguments in case that Medicaid managers say could impact states' flexibility and discretion in allocating resources.
  Patti's Comment: This is an important case – Michigan did something similar to lots of children with disabilities by changing the definition of private duty nursing…stay tuned.