ACLU Files New UHIP-Related Lawsuit Over Medicaid Termination Notices
Posted: Jan, 02, 2018
The ACLU of Rhode Island today filed a class-action lawsuit claiming that participants in a Medicaid program run by the state are not being given proper notice before being kicked off the program, leading to a loss of income that the suit says puts low-income residents “at risk of losing their homes and their utilities and deprives them of funds needed for their daily living expenses, including food.” The suit, against the state Executive Office of Health and Human Services (EOHHS), ties the improper notice to the state’s infamous UHIP computer system, the subject of another pending ACLU suit regarding food stamp benefit delays.
The lawsuit, filed in U.S. District Court by ACLU of RI volunteer attorney Ellen Saideman, involves the Medicaid Payment Program (MPP). Medicaid provides the MPP program for certain individuals who are elderly or have disabilities and are eligible to receive Medicare benefits. Under the MPP program, Medicaid pays these individuals’ costs for participating in Medicare, including their monthly premium for Medicare Part B. This program thus provides significant financial assistance to those who qualify.
After UHIP went live, Rhode Island Legal Services (RILS) began getting calls from multiple clients who received notices from the Social Security Administration (SSA) that the state had stopped paying their Medicare premiums and, therefore, SSA had deducted two months of premiums from their monthly Social Security benefit. The fact pattern in each case was the same: the clients reported not receiving any advance notice at all from EOHHS that their MPP participation was being terminated.
Although RILS was able to resolve these complaints on an individual basis with DHS when they were brought to the agency’s attention, the suit claims that EOHHS “has failed to fix the problem systemically and reinstate every individual whose MPP benefits were terminated and ensure that each individual received all the retroactive benefits that were due.”
More recently, claims the suit, a new problem has arisen: individuals are getting notices, but the notices give no reason for the termination, an important piece of information required by federal law.
The two named plaintiffs in the lawsuit, Christopher Scherwitz and John Figuried, epitomize both of these problems. Scherwitz receives Social Security Disability because of his disabilities. Last June, his MPP benefits stopped, and the Social Security Administration began taking $134 out of his benefit check every month. The suit claims he never received any advance written notice from the State that his MPP benefits would stop, and the reduction in benefits has required him to borrow money from his mother, who as a result, has fallen behind in her own utility payments and fears a utility shutoff.
Figuried is 82 years old, and he receives Social Security benefits because of his age, and has received MPP benefits for many years. In October, he received a notice from the State that his MPP benefits would be ending as of October 31, but the space on the notice for the reasons why his benefits were ending was blank.
The lawsuit argues that the state’s failure to “provide adequate advance written notice and opportunity to request a fair hearing to MPP recipients prior to terminating their MPP benefits violates” federal Medicaid laws and the clients’ rights to due process. The suit seeks a court order barring EOHHS from “from terminating MPP benefits without adequate advance notice” requiring the agency “to reinstate individuals who were terminated from MPP benefits without adequate advance notice and instruct SSA to provide them with retroactive benefits.”
ACLU attorney Saideman said today: “Rhode Island Legal Services first brought this problem to the state in January 2017, about a year ago. It is outrageous that low-income individuals are still being deprived of these important benefits without the notice required by federal law. And, given the problems that have plagued UHIP, I’m confident that there is no valid reason why our clients and other class members have had their benefits terminated.”
ACLU of Rhode Island executive director Steven Brown added: “State officials keep on talking about how hard they are working to fix UHIP. Nobody should find that response acceptable anymore. It’s been fifteen long months for many of the state’s poorest residents, so our response is: you clearly aren’t working hard enough.”
To read the full text of the lawsuit, click here.