ILNews

Court of Appeals rules against FSSA

Jennifer Nelson
January 1, 2008
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The Indiana Court of Appeals reversed a trial court's dismissal of an action against the Family and Social Services Administration regarding the denial of Medicaid applications, finding the FSSA relied on an incorrect statute to justify the denial of new evidence supporting a disability claim on the appellate level.

In William Curtis, Gary Stewart, and Walter Raines, on behalf of themselves and those similarly situated v. E. Mitchell Roob Jr., as Secretary of Indiana Family and Social Services Administration, and Jeff Wells, as director of the Office of Medicaid Policy and Planning in the FSSA, No. 49A02-0801-CV-23, the Court of Appeals found the FSSA wasn't following federal or Indiana's Medicaid statutes that provide if the decision of a local evidentiary hearing is adverse to the applicant or recipient, the agency has to tell the applicant of his right to request his appeal be a de novo hearing.

The plaintiffs in this case allege the FSSA violated due process rights of Medicaid claimants with its policy that prohibits applicants from offering evidence at the appeal hearing that wasn't introduced in the initial application. When the plaintiffs were denied benefits after review of their applications, they requested the review of the denial by an administrative law judge. The administrative law judge wouldn't accept new evidence that wasn't included in the original application.

In its brief in this case, the FSSA doesn't even acknowledge any provisions of Indiana's Medicaid statutes, instead relying on a provision in the Administrative Orders and Procedures Act that allows an administrative law judge to exclude "irrelevant" evidence, Judge Melissa May wrote in a footnote.

"Our own Medicaid statutes explicitly permit the ALJ to receive additional evidence in the Medicaid hearing: 'At the hearing, the applicant and county office may introduce additional evidence,'" she wrote.

Medicaid regulations explicitly refer to a de novo hearing, which allows for the consideration of new evidence. In light of the Medicaid fair hearing regulations, the complaint by the plaintiffs shouldn't have been dismissed, the court ruled.
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  1. It is amazing how selectively courts can read cases and how two very similar factpatterns can result in quite different renderings. I cited this very same argument in Brown v. Bowman, lost. I guess it is panel, panel, panel when one is on appeal. Sad thing is, I had Sykes. Same argument, she went the opposite. Her Rooker-Feldman jurisprudence is now decidedly unintelligible.

  2. November, 2014, I was charged with OWI/Endangering a person. I was not given a Breathalyzer test and the arresting officer did not believe that alcohol was in any way involved. I was self-overmedicated with prescription medications. I was taken to local hospital for blood draw to be sent to State Tox Lab. My attorney gave me a cookie-cutter plea which amounts to an ALCOHOL-related charge. Totally unacceptable!! HOW can I get my TOX report from the state lab???

  3. My mother got temporary guardianship of my children in 2012. my husband and I got divorced 2015 the judge ordered me to have full custody of all my children. Does this mean the temporary guardianship is over? I'm confused because my divorce papers say I have custody and he gets visits and i get to claim the kids every year on my taxes. So just wondered since I have in black and white that I have custody if I can go get my kids from my moms and not go to jail?

  4. Someone off their meds? C'mon John, it is called the politics of Empire. Get with the program, will ya? How can we build one world under secularist ideals without breaking a few eggs? Of course, once it is fully built, is the American public who will feel the deadly grip of the velvet glove. One cannot lay down with dogs without getting fleas. The cup of wrath is nearly full, John Smith, nearly full. Oops, there I go, almost sounding as alarmist as Smith. Guess he and I both need to listen to this again: https://www.youtube.com/watch?v=CRnQ65J02XA

  5. Charles Rice was one of the greatest of the so-called great generation in America. I was privileged to count him among my mentors. He stood firm for Christ and Christ's Church in the Spirit of Thomas More, always quick to be a good servant of the King, but always God's first. I had Rice come speak to 700 in Fort Wayne as Obama took office. Rice was concerned that this rise of aggressive secularism and militant Islam were dual threats to Christendom,er, please forgive, I meant to say "Western Civilization". RIP Charlie. You are safe at home.

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