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Arguments set in Medicaid appeal

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Indiana Lawyer Rehearing

In a case that involves whether Medicaid applicants who were rejected can include information that was not in their initial applications when they appeal, the Indiana Supreme Court has set oral arguments for March 3 at 9 a.m.

In its July 21 decision in Anne Waltermann Murphy, et al. v. William Curtis, et al., No. 49A04-0909-CV-503, the majority of an Indiana Court of Appeals panel reversed the decision of a Marion Superior judge and found in favor of Anne Waltermann Murphy in her official capacity as secretary of Indiana Family and Social Services Administration and Patricia Casanova in her official capacity as director of the Office of Medicaid Policy and Planning of the Indiana Family and Social Services Administration.

One of the Court of Appeals judges dissented, writing that she disagreed with the majority’s conclusion that an administrative law judge’s “refusal to consider evidence of conditions not disclosed on a Medicaid disability application does not violate federal Medicaid law and the Due Process Clause of the Fourteenth Amendment.”

American Civil Liberties Union of Indiana attorneys who represented the three named plaintiffs – William Curtis, Gary Stewart, and Walter Raines – as well as attorneys for Indiana Legal Services who frequently represent Medicaid applicants in their appeals, have expressed concern that because applicants are unsure of what is needed for successful applications, with or without assistance from a family member or social worker, they should be able to present additional evidence at appeals.

Lawyers in the attorney general’s office who represented Murphy and Casanova argued that in many cases, applicants do have someone who should be able to provide enough information to help with applications.

However, attorneys for the plaintiffs said that while this is sometimes the case, the three plaintiffs’ experiences in a relatively short amount of time led them to believe there were many more examples of failed appeals where the applicants should have been allowed to present more evidence at appeal than what was in the application.

In Curtis’ case, his caseworker advised him only to report his mental health issues and not include his orthopedic problems. Stewart, who applied so he could receive medical attention, which is a fairly common reason to apply for Medicaid, wasn’t diagnosed with his pre-existing condition of congestive heart failure until after he submitted his application. He did not know what was wrong at the time he filled out his application. Raines “either had trouble identifying his illness or he didn’t consider it disabling,” said ACLU of Indiana attorney Gavin Rose, who represents the plaintiffs.

Rehearing "Medicaid applicants facing 'tremendous hurdles'?" IL Sept. 29-Oct. 12, 2010

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  1. Thank you, John Smith, for pointing out a needed correction. The article has been revised.

  2. The "National institute for Justice" is an agency for the Dept of Justice. That is not the law firm you are talking about in this article. The "institute for justice" is a public interest law firm. http://ij.org/ thanks for interesting article however

  3. I would like to try to find a lawyer as soon possible I've had my money stolen off of my bank card driver pressed charges and I try to get the information they need it and a Social Security board is just give me a hold up a run around for no reason and now it think it might be too late cuz its been over a year I believe and I can't get the right information they need because they keep giving me the runaroundwhat should I do about that

  4. It is wonderful that Indiana DOC is making some truly admirable and positive changes. People with serious mental illness, intellectual disability or developmental disability will benefit from these changes. It will be much better if people can get some help and resources that promote their health and growth than if they suffer alone. If people experience positive growth or healing of their health issues, they may be less likely to do the things that caused them to come to prison in the first place. This will be of benefit for everyone. I am also so happy that Indiana DOC added correctional personnel and mental health staffing. These are tough issues to work with. There should be adequate staffing in prisons so correctional officers and other staff are able to do the kind of work they really want to do-helping people grow and change-rather than just trying to manage chaos. Correctional officers and other staff deserve this. It would be great to see increased mental health services and services for people with intellectual or developmental disabilities in the community so that fewer people will have to receive help and support in prisons. Community services would like be less expensive, inherently less demeaning and just a whole lot better for everyone.

  5. Can I get this form on line,if not where can I obtain one. I am eligible.

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