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Thread: Medicaid recipients accuse state of denying them medical equipment/Lawsuit Brought In Denials Of Medical Equipment

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    Senior Member Max's Avatar
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    Medicaid recipients accuse state of denying them medical equipment/Lawsuit Brought In Denials Of Medical Equipment

    Medicaid recipients accuse state of denying them medical equipment
    Associated Press

    November 6 2002

    NEW HAVEN, Conn. -- Three Medicaid recipients filed a class-action lawsuit Wednesday, accusing the state of denying them access to urgently needed medical equipment.

    The lawsuit was filed against Department of Social Services Commissioner Patricia Wilson-Coker in U.S. District Court in New Haven.

    The three plaintiffs alleged that hundreds of other Medicaid recipients, including many with low incomes and disabilities, also need the equipment they were denied.

    Their lawyers claimed that denial of equipment is illegal and results in higher costs to the state.

    Kevin Brophy, a lawyer for one of the plaintiffs, said that if people are denied medical equipment, "they will most likely be forced into nursing homes at a far greater cost to the state's Medicaid program. Does that make any sense for the taxpayers?"

    The lawsuit says the equipment denied to the plaintiffs included:

    - A stair glide for an elderly man who has to crawl up the stairs of his apartment to get to the bathroom.

    - An electronic device that allows a quadriplegic to operate his hospital bed, control the temperature, open a door and use a telephone.

    - A specialized bed for a person with a spinal cord injury who suffers from excruciating back pain.

    Wilson-Coker did not immediately return a telephone message left at her office Wednesday night. Her home phone number was not listed.

    David Dearborn, a spokesman for the Social Services Department, said he had not seen the lawsuit and could not immediately comment Wednesday night. He said the department may comment after reviewing and researching the allegations.

    Lawyers for the plaintiffs criticized the department for denying Medicaid recipients the equipment based on a manual used for the Medicare program. They said Medicare, a supplemental health insurance program, is not designed for low-income people and has more limited benefits than Medicaid.

    Sheldon Toubman, another lawyer for the plaintiffs, said, "It is most unfortunate that low-income elderly people and disabled folks would have to file a lawsuit just to gain access to urgently needed equipment which the federal government already instructed the department to provide, and which the department already agreed to provide in new regulations."

    The plaintiffs are seeking an immediate injunction for themselves and, if the class action is approved by a judge, an injunction on behalf of all other low-income and disabled people who are being denied the equipment.

    The New Haven Legal Assistance Association and the Connecticut Legal Services Inc. are representing the plaintiffs.


    Copyright 2002 Associated Press


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    "Those who seek to predict the future... might first look to the past. The past is a mirror -- and those who ignore its sometimes dark reflection, are doomed to repeat it... Will it be those seeking redemption who shall decide the future... or will those driven only by greed and envy shape our destiny? Even a hundred years later, the outcome is still very much in doubt. .." Outer Limits(Heart's Desire)

    [This message was edited by Max on Nov 10, 2002 at 02:05 PM.]

  2. #2
    Senior Member Max's Avatar
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    Medicaid recipients accuse state of denying them medical equipment

    Medicaid recipients accuse state of denying them medical equipment
    Associated Press

    November 6, 2002

    NEW HAVEN, Conn. -- Three Medicaid recipients filed a class-action lawsuit Wednesday, accusing the state of denying them access to urgently needed medical equipment.

    The lawsuit was filed against Department of Social Services Commissioner Patricia Wilson-Coker in U.S. District Court in New Haven.

    The three plaintiffs alleged that hundreds of other Medicaid recipients, including many with low incomes and disabilities, also need the equipment they were denied.

    Their lawyers claimed that denial of equipment is illegal and results in higher costs to the state.

    Kevin Brophy, a lawyer for one of the plaintiffs, said that if people are denied medical equipment, "they will most likely be forced into nursing homes at a far greater cost to the state's Medicaid program. Does that make any sense for the taxpayers?"

    The lawsuit says the equipment denied to the plaintiffs included:

    - A stair glide for an elderly man who has to crawl up the stairs of his apartment to get to the bathroom.

    - An electronic device that allows a quadriplegic to operate his hospital bed, control the temperature, open a door and use a telephone.

    - A specialized bed for a person with a spinal cord injury who suffers from excruciating back pain.

    Wilson-Coker did not immediately return a telephone message left at her office Wednesday night. Her home phone number was not listed.

    David Dearborn, a spokesman for the Social Services Department, said he had not seen the lawsuit and could not immediately comment Wednesday night. He said the department may comment after reviewing and researching the allegations.

    Lawyers for the plaintiffs criticized the department for denying Medicaid recipients the equipment based on a manual used for the Medicare program. They said Medicare, a supplemental health insurance program, is not designed for low-income people and has more limited benefits than Medicaid.

    Sheldon Toubman, another lawyer for the plaintiffs, said, "It is most unfortunate that low-income elderly people and disabled folks would have to file a lawsuit just to gain access to urgently needed equipment which the federal government already instructed the department to provide, and which the department already agreed to provide in new regulations."

    The plaintiffs are seeking an immediate injunction for themselves and, if the class action is approved by a judge, an injunction on behalf of all other low-income and disabled people who are being denied the equipment.

    The New Haven Legal Assistance Association and the Connecticut Legal Services Inc. are representing the plaintiffs.


    Copyright © 2002, The Associated Press

    ==============================
    "Those who seek to predict the future... might first look to the past. The past is a mirror -- and those who ignore its sometimes dark reflection, are doomed to repeat it... Will it be those seeking redemption who shall decide the future... or will those driven only by greed and envy shape our destiny? Even a hundred years later, the outcome is still very much in doubt. .." Outer Limits(Heart's Desire)



  3. #3
    Senior Member Max's Avatar
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    Lawsuit Brought In Denials Of Medical Equipment

    Lawsuit Brought In Denials Of Medical Equipment
    By EDMUND H. MAHONY
    Courant Staff Writer

    November 9 2002

    For the second time in a half-dozen years, low-income patients with severe medical problems are contending in a class-action lawsuit that state Medicaid administrators are unfairly and arbitrarily denying them critical medical equipment.

    The federal suit, filed on behalf of three Connecticut Medicaid patients by the New Haven Legal Assistance Association, contends the state Department of Social Services is improperly refusing to pay for medical equipment that the patients need to improve their health and live independently.

    The patients say that social services Commissioner Patricia A. Wilson-Coker, who administers the Medicaid program, is not fairly evaluating medical requests for prescribed equipment, such as special mattresses and wheelchairs. Rather, the suit contends, the department has refused to pay for medical equipment based on a list of procedures approved by the separate Medicare program.

    The "defendant commissioner has adopted an unwritten and unpublished policy of denying Medicaid payment for any equipment which is not covered by the federal Medicare program, a separate and distinct federal program of health care," the lawsuit says.

    Legal assistance lawyer Sheldon V. Toubman said a key component of Medicaid, a long-term program for low-income patients, is to provide treatment needed to keep them out of expensive long-term care institutions.

    Officials at the state Department of Social Services declined to discuss the suit.

    Although the suit is written to obtain treatment for an entire class of low-income patients, it specifically describes the experiences of three patients.

    One is a 51-year-old single mother from West Haven who suffered a severe spinal cord injury in 1999. Her physician has said she needs a special air mattress to avoid life-threatening skin ulcers. A state hearing officer approved a special mattress for the woman, but the department overruled the officer, saying the special equipment is not on the approved Medicare list.

    The second patient is an 80-year-old New Milford man who is unable to climb the stairs in his apartment because of osteoarthritis and advanced spastic paralysis of his legs. Without a device to carry him up and down stairs, the man faces institutionalization, the suit says. The state will not reimburse the cost of the device, the suit says.

    The third patient is a 57-year-old quadriplegic who lives with his parents in Rocky Hill and has only limited use of one hand. The suit says the state has refused to reimburse the cost of a device that would allow him to operate a telephone, a thermostat, lights and a wheelchair.

    In 1997, the New Haven Legal Assistance Association brought a similar suit against the social services department. In that case, the suit accused the state of compiling its own list of approved Medicaid expenses and arbitrarily denying requests for medical equipment not on it.

    In 1999, then-newly appointed Wilson-Coker settled the suit by agreeing to update the list of eligible equipment annually and allow recipients to obtain items not on the list, when necessary.

    The legal-aid lawyers had then won a court order against the department in U.S. District Court. The social services department later convinced an appellate court to dissolve the order. The suit was settled after the U.S. Supreme Court returned the case to the district court and federal health authorities clarified federal regulations relied on by state Medicaid officials.
    Copyright 2002, Hartford Courant


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    ==============================
    "Those who seek to predict the future... might first look to the past. The past is a mirror -- and those who ignore its sometimes dark reflection, are doomed to repeat it... Will it be those seeking redemption who shall decide the future... or will those driven only by greed and envy shape our destiny? Even a hundred years later, the outcome is still very much in doubt. .." Outer Limits(Heart's Desire)



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