Monday, February 6, 2017
Plaintiffs’ counsel filed a motion for an award of litigation costs, including attorneys’ fees and related expenses, in DL v. District of Columbia, a class action related to special education services for preschool-aged children in the District of Columbia. Defendants are scheduled to file an opposition to that motion. In addition, subclass members may file objections to that motion. For additional detail, click here for a copy of the notice related to this motion. Click here for additional information regarding this case. Read more . . .
Wednesday, December 7, 2016
On July 12, 2016, the U.S. District Court entered an Order in the long-running Salazar v.
Read more . . .
Thursday, August 25, 2016
On July 12, 2016, the District Court entered an Order in the long-running Salazar v. District of Columbia class action case providing immediate relief to self-identified Medicaid applicants and beneficiaries who cannot access their benefits as a result of the District of Columbia government’s delays and errors in processing Medicaid eligibility applications and renewals.
First, the District must grant provisional eligibility to all individuals who inform the government that more than 45 days have elapsed without a determination on their non-disability application for Medicaid benefits. The District must grant provisional eligibility to such individual applicants until it makes an eligibility determination on the application and provides them written notice of the decision. Read more . . .
Thursday, May 26, 2016
In DL v. District of Columbia, on May 18, 2016, the district court found the District of Columbia liable for violating children’s rights under the Individuals with Disabilities Education Act (IDEA) and District law through November 12, 2015, and the Rehabilitation Act until March 22, 2010, and issued a sweeping injunction. The district court enjoined the District of Columbia from further violations of the IDEA and District law, and ordered specific corrective actions, including that the District ensure that (1) at least 8.5 percent of children between the ages of three and five who reside in the District or are wards of the District receive necessary special education and related services, (2) at least 95 percent of all children between the ages of three and five referred for special education services receive a timely eligibility determination, and (3) at least 95 percent of all children receiving Part C services (early intervention services for children up to three years of age) that are found eligible for Part B services (special education and related services for children ages three and older) receive a smooth and effective transition to those Part B services by their third birthdays.Read more . . .
Thursday, March 13, 2014
The District of Columbia issued a document at the Medical Care Advisory Committee (MCAC) meeting on February 26, 2014, which states that certain Medicaid beneficiaries will be subject to passive renewal for Medicaid beginning on July 1, 2014. These Medicaid beneficiaries – who are subject to the MAGI (Modified Adjusted Gross Income) method of determining eligibility for Medicaid – will not be terminated from Medicaid from January 1, 2014, though June 30, 2014, even if they ordinarily would have had to recertify their Medicaid benefits during that time period. Medicaid beneficiaries subject to the MAGI method include families with children under age 21, pregnant women, and childless adults aged 21-64.
On the other hand, Medicaid beneficiaries who are not subject to the MAGI method of determining eligibility for Medicaid, namely, those over age 65, the disabled, the blind, and those receiving long-term care services, are not subject to passive recertification for Medicaid. These Medicaid beneficiaries remain subject to the usual D.C. Medicaid recertification process.
To read the District of Columbia’s document, please click here. If you have questions about or need assistance with Medicaid recertification, contact Terris, Pravlik & Millian, LLP, at 202-682-0578.
Wednesday, March 12, 2014
In the fall of 2013, the District of Columbia failed to update the correct address for submission of Medicaid reimbursement claims on its forms and website for two months after it moved offices. Therefore, in an Order issued on February 18, 2014, the United States District Court for the District of Columbia ruled that Medicaid beneficiaries who were delayed in submitting a Medicaid reimbursement claim because they had the wrong address are entitled to an extension of time to submit reimbursement claims. The Court directed the District of Columbia to place notice of the extension of time to March 31, 2014, on the website of the Department of Health Care Finance (DHCF). Medicaid beneficiaries who are class members may obtain free assistance with submitting reimbursement claims by contacting Terris, Pravlik & Millian, LLP, at 202-682-0578. To read the Court’s Order and see the press release, click here.
Tuesday, October 29, 2013
In a decision rendered on October 18, 2013, the United States District Court for the District of Columbia ruled that it would end its oversight of the protection of due process rights of the Salazar plaintiff class at the time of recertification for Medicaid benefits because of a new federal regulation changing the procedures for Medicaid recertification to a passive system. The District of Columbia stated in court papers that the new passive system will be fully in place for the Salazar plaintiff class by October 2014. Although the district court ended its oversight of the Medicaid recertification system, it stated: “members of the plaintiff class can also contact Plaintiffs' counsel, as they have been doing over the years, to obtain legal assistance.” Therefore, Terris, Pravlik & Millian, LLP will continue to assist Medicaid beneficiaries in the Salazar class who have problems recertifying their Medicaid benefits. To read the Court’s decision, use this link.
Thursday, July 18, 2013
A recent order of the Office of Administrative Hearings (John P. Dean, Administrative Law Judge) signifies strong support for the due process rights of DC Medicaid beneficiaries.
BR, a Salazar class member and DC Medicaid beneficiary, filed for a fair hearing after her managed care organization (MCO), Health Services for Children with Special Needs, Inc. (HSCSN), stopped payment to her therapy provider, effectively terminating her prescribed services. Although HSCSN refused to pay for any visits occurring in October 2012 or later, the provider was only notified of that fact in January 2013. The beneficiary received a copy of the letter denying payment sent to the provider. In February 2013, the beneficiary filed for a fair hearing because her services had been terminated without notice, requesting that her services continue pending the resolution of the hearing.
HSCSN resisted this request, claiming that the beneficiary’s claim for continued services pending the resolution of the hearing was barred, because she filed the request more than ten days after she received notice of the action in a letter to the provider denying payment. The Department of Health Care Finance (DHCF) filed a paper supporting the position of the Medicaid beneficiary that benefits pending the resolution of the fair hearing were appropriate.
Although the ALJ agreed with HSCSN that the beneficiary had requested the continued services more than ten days after she received the denial letter, because that denial letter was addressed to, and intended for, the provider, and only discussed the provider’s rights in relation to the decision, the ALJ held that the beneficiary had never received notice within the meaning of the Medicaid statutes and regulations, and so the ten-day deadline had never begun to run, entitling the beneficiary to benefits pending the resolution of the hearing. The ALJ held that, under the DC Public Assistance Act, no deadline regarding administrative hearings may start to run until the beneficiary receives clear notice of the deadline and of how to file the hearing request. To see the decision, use this link.
Monday, July 15, 2013
WASHINGTON--U.S. District Judge Gladys Kessler will hold a public status conference on Thursday July 25, 2013 at 10:00 AM in response to Chartered Healthcare’s decision to pull out of the District of Columbia’s Medicaid managed care program. At the conference, the District of Columbia will present its plan to ensure that, despite the fact that Chartered is no longer participating in the District’s program, Medicaid beneficiaries will continue to receive the health care services they are entitled to, uninterrupted.
Click here to read more.
Tuesday, June 18, 2013
D.L. v. District of Columbia, D.D.C., Civ. No. 05-1437
In 2005, the firm brought D.L. v. District of Columbia in the District Court for the District of Columbia. The case is a class action challenging the District of Columbia’s systemic failure to identify, locate, and evaluate three to five year old children with disabilities, and offer them a free appropriate public education, in violation of the Individuals with Disabilities Education Act (IDEA), Section 504 of the Rehabilitation Act, and other law.
On August 10, 2010, the district court granted plaintiffs’ motion for partial summary judgment, finding the defendants liable through 2007 for violating plaintiffs’ rights under the IDEA, the Rehabilitation Act, and District of Columbia law. The court subsequently held a trial on liability related to subsequent years.
On November 16, 2011, after trial, the district court ruled for the plaintiff class, finding that defendants had violated the IDEA, Section 504 of the Rehabilitation Act, and District of Columbia law through the date of the trial. The district court ordered the District of Columbia to cease these violations and required the District of Columbia to take significant steps to ensure that it complies with its obligations to provide special education and related services. The district court did not address the process for awarding compensatory education or reimbursement relief to individual members of the class.
Before the district court issued its decision after the trial, the Supreme Court issued its decision inWal-Mart Stores, Inc. v. Dukes, which related to class certification. Before trial, defendants had moved to decertify the class and that motion was still pending when Wal-Mart was decided. Plaintiffs opposed defendants’ motion and moved to amend the initial class certification to add subclasses and to recertify the existing Rule 23(b)(2) class as a hybrid class, with claims for comprehensive declaratory and injunctive relief certified under Rule 23(b)(2) and individual claims for compensatory education and/or reimbursement certified under Rule 23(b)(3). The court granted plaintiffs’ motion for hybrid certification and denied in part defendants’ motion to decertify the class. The district court concluded that the requested subclasses were unnecessary.
The District of Columbia appealed the district court’s decisions to the U.S. Court of Appeals for the District of Columbia Circuit (case numbers 11-7153 and 12-7042), arguing that the case was wrongly certified as a class action. AARP, the Bazelon Center for Mental Health Law, the Council of Parent Attorneys and Advocates, the Lawyers’ Committee for Civil Rights Under Law, the National Disability Rights Network, the National Health Law Program, the National Federation for the Blind, and the University Legal Services Protection & Advocacy Program filed an amici curiae brief in support of plaintiffs-appellees.
On April 12, 2013, the court of appeals issued its opinion that “vacate[d] the order certifying the class and, consequently, the orders finding liability and ordering relief to that class” and “remand[ed] the case to the district court for reconsideration of whether a class, classes, or subclasses may be certified, and if so, thereafter to redetermine liability and appropriate relief.”
On June 4, 2013, plaintiffs moved in the district court for recertification based on four subclasses, each class related to one of four claims, and for reinstatement of the liability and injunctive determinations.
If you have any questions about the case, please call Todd Gluckman at 202-204-8482.
Court of Appeals’ Opinion, dated April 12, 2013
Memorandum Opinion Granting Class Certification, dated August 25, 2006
Memorandum Opinion (Class Action Issues), dated November 16, 2011
Memorandum Opinion & Findings of Fact And Conclusions of Law, dated November 16. 2011
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