Managed Care Class Action Lawsuit

Managed Care Lawsuit Update:

March 2018

DRI, in conjunction with co-counsel, filed a class action on behalf of Iowa Medicaid beneficiaries with intellectual disabilities, physical disabilities, and brain injuries who receive home and community based services from one of three waiver programs. 

By way of background, Iowa transitioned last year from a state run Medicaid program to a private, for-profit managed care plans.  Initially the plans maintained some of the services for members with severe disabilities who need extensive home and community-based services to be able to live integrated into their communities and having access to community life similar to non-disabled individuals.  However, the managed care companies claimed they were losing too much money on Medicaid contracts and began cutting members’ necessary home and community-based services without any significant changes to their health needs, and not providing proper notice nor an opportunity to appeal. 

The class action was filed against the Governor and the Director of Department of Human Services in their official capacities (however, the Governor was later dismissed).  Plaintiffs sought declaratory and both preliminary and permanent injunctive relief to halt the terminations and reductions of home and community-based services by Defendants and their agents until there is compliance with the requirements of the Medicaid Act, the U.S. Constitution, Iowa Constitution, the Americans with Disabilities Act and Section 504 of the Rehabilitation Act.  Plaintiffs also petitioned for class certification.  DRI represents plaintiffs along with co-counsel from the National Health Law Project and Roxanne Conlin & Associates, P.C.

The court denied the request for class certification on November 21, 2017.  The court later denied the request for preliminary injunction on November 28, 2017.  

On February 2, 2018, Judge Goodgame Ebinger dismissed the class action lawsuit against the state of Iowa’s Department of Human Services director.  The judge ruled that as AmeriHealth Caritas of Iowa MCO has ceased operating in Iowa, the Plaintiffs claims are moot. 

DRI disagrees with the judge’s decision.  Regardless of which managed care company handles the member’s waiver services, the Iowa Department of Human Services is ultimately responsible for ensuring that Iowans have the Medicaid services they need.  DRI will continue to review if there is compliance with the HCBS waivers and services for Iowans. 

If you are experiencing any reduction, denial or termination of your home and community-based waiver services, please give DRI a call at 515-278-2502 or 800-779-2502. 

 65-Order dismissing managed care suit

Six Iowans with significant disabilities filed a class action lawsuit in federal court to stop Governor Kim Reynolds and Department of Human Services Director Charles Palmer from arbitrarily terminating or reducing the Medicaid services they depend on to stay in their homes in the community.  If it were not for these services, the Plaintiffs and others like them would be confined in hospitals, nursing facilities or intermediate care facilities.

Find out everything you need to know about the class action lawsuit challenging the arbitrary termination of HCBS services here. Click the following link for the Press Release

Here you will find all of the pleadings filed in the class action lawsuit along with the related articles that have been published. See the following links for more information.

Copy of the Complaint

Motion for Class Action Certification

Brief in Support of Motion for Plaintiff’s Class Action Certification

Motion for Pro Hac Vice of Abigail Coursolle*

Motion for Pro Hac Vice of Elizabeth Edwards*

*Pro Hac Vice grants an out-of-district attorney temporary jurisdiction in another district*

Motion for Class Certification

Brief in Support of Plaintiff Motion for Class Certification

Motion for Preliminary Injunction and Request for Hearing

Plaintiff’s Brief in Support of Motion For Preliminary Injunction

Resistance to Motion for Injunctive Relief

Resistance to Motion for Class Certification

Brief in Resistance to Motion for Class Certification

Plantiffs’ Reply to Defendants Resistance to Motion for Class Certification

Plaintiffs’ Reply in Support for Motion for Preliminary Injunction

Defendants Motion to Dismiss

Defendant Brief in Support of Motion to Dismiss

Plaintiffs’ Resistance to Defendants’ Motion to Dismiss

Defendants’ Reply Brief in Support of Motion to Dismiss