[Education and Welfare] FW: Court Grants Preliminary Injunction and Class Certification inNorth Carolina Medicaid Case

Fri Mar 30 17:36:59 CDT 2012

From: NHeLP [mailto:no-reply at healthlaw.org] 
Sent: Thursday, March 29, 2012 6:05 PM
To: quieth2o at ktis.net
Subject: Court Grants Preliminary Injunction and Class Certification inNorth
Carolina Medicaid Case

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For Immediate Release

Thursday, March 29, 2012

Contact: Vincent Eng

+1 703 981 6636

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Court Grants Preliminary Injunction and Class Certification in North
Carolina Medicaid Case

Raleigh, NC - A federal District Court today ordered the State of North
Carolina to halt reductions to home and community based services and restore
lost services until the state Medicaid agency and its managed care
contractor, Piedmont Behavioral Healthcare (PBH), comply with legal
requirements for providing Medicaid beneficiaries with adequate notices and
opportunities for impartial hearings when their services are denied, reduced
or terminated. The Court noted that without an injunction, the
plaintiffs-children and adults with disabilities-would experience
deteriorating health, financial strains, and the threat of having to go into
institutions to get care. "We are gratified by the court's thorough, careful
analysis and hopeful that the state and PBH will quickly accept this
decision and correct their illegal practices," said Doug Sea, an attorney at
Legal Services of Southern Piedmont. "Scores of our most vulnerable citizens
desperately need the services that have been taken away from them, without
due process, to be promptly restored." 

Judge Louise Flanagan's decision found that the plaintiffs are likely to
succeed on the merits of their legal claims that the Medicaid agency and PBH
are not complying with the most basic federal constitutional and statutory
requirements for participating in the Medicaid program. "Health care
coverage is complicated," said National Health Law Program attorney Jane
Perkins. "The court's decision is welcome and important because it
recognizes that the Medicaid agency and its managed care plan, PBH, have
obligations to make sure that people with disabilities who are insured
through Medicaid get timely and accurate information about why their
services are being reduced or terminated and what they can do about it if
they object."  

The suit, L.S., et al. v. Delia, et al. (No. 5:11-CV-354FL), was brought by
Medicaid beneficiaries who suffer from chronic developmental disabilities
and require significant medical or personal care. North Carolina operates a
Home and Community Based Care program (North Carolina Innovations Waiver),
which provides plaintiffs with access to services so that they can remain in
their homes and avoid costly institutionalization. In March of 2011, PBH
began implementing a new budgeting system which reduced services for
beneficiaries that had previously been found necessary, even though their
underlying conditions had not changed, and without the legally required
notice explaining why the action was being taken. "Once again, the courts
confirm that the desire to save resources does not allow a provider or state
to deny due process," said Disability Rights North Carolina attorney John
Rittelmeyer.  

Click
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=> here to view the court's decision.  

For questions or comments about the case, contact: 

Doug Sea

Legal Services of Piedmont

dougs at lssp.org 

704-971-2593 

Jane Perkins

National Health Law Program 

perkins at healthlaw.org

919-968-6308

John Rittelmeyer

Disability Rights NC

John.rittelmeyer at disabilityrightsnc.org

919-856-2195 

###

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