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Update on Medicaid Class Action Lawsuit

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. 

Read the court dismissal here 65-Order dismissing medicaid managed care suit.

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