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. The voices of the prophets are more on blogs than subway walls these days, Dawn. Here is the voice of one calling out in the wilderness ... against a corrupted judiciary ... that remains corrupt a decade and a half later ... due to, so sadly, the acquiescence of good judges unwilling to shake the forest ... for fear that is not faith .. http://www.ogdenonpolitics.com/2013/09/prof-alan-dershowitz-on-indiana.html

  2. So I purchased a vehicle cash from the lot on West Washington in Feb 2017. Since then I found it the vehicle had been declared a total loss and had sat in a salvage yard due to fire. My title does not show any of that. I also have had to put thousands of dollars into repairs because it was not a solid vehicle like they stated. I need to find out how to contact the lawyers on this lawsuit.

  3. It really doesn't matter what the law IS, if law enforcement refuses to take reports (or take them seriously), if courts refuse to allow unrepresented parties to speak (especially in Small Claims, which is supposedly "informal"). It doesn't matter what the law IS, if constituents are unable to make effective contact or receive any meaningful response from their representatives. Two of our pets were unnecessarily killed; court records reflect that I "abandoned" them. Not so; when I was denied one of them (and my possessions, which by court order I was supposed to be able to remove), I went directly to the court. And earlier, when I tried to have the DV PO extended (it expired while the subject was on probation for violating it), the court denied any extension. The result? Same problems, less than eight hours after expiration. Ironic that the county sheriff was charged (and later pleaded to) with intimidation, but none of his officers seemed interested or capable of taking such a report from a private citizen. When I learned from one officer what I needed to do, I forwarded audio and transcript of one occurrence and my call to law enforcement (before the statute of limitations expired) to the prosecutor's office. I didn't even receive an acknowledgement. Earlier, I'd gone in to the prosecutor's office and been told that the officer's (written) report didn't match what I said occurred. Since I had the audio, I can only say that I have very little faith in Indiana government or law enforcement.

  4. One can only wonder whether Mr. Kimmel was paid for his work by Mr. Burgh ... or whether that bill fell to the citizens of Indiana, many of whom cannot afford attorneys for important matters. It really doesn't take a judge(s) to know that "pavement" can be considered a deadly weapon. It only takes a brain and some education or thought. I'm glad to see the conviction was upheld although sorry to see that the asphalt could even be considered "an issue".

  5. In response to bryanjbrown: thank you for your comment. I am familiar with Paul Ogden (and applaud his assistance to Shirley Justice) and have read of Gary Welsh's (strange) death (and have visited his blog on many occasions). I am not familiar with you (yet). I lived in Kosciusko county, where the sheriff was just removed after pleading in what seems a very "sweetheart" deal. Unfortunately, something NEEDS to change since the attorneys won't (en masse) stand up for ethics (rather making a show to please the "rules" and apparently the judges). I read that many attorneys are underemployed. Seems wisdom would be to cull the herd and get rid of the rotting apples in practice and on the bench, for everyone's sake as well as justice. I'd like to file an attorney complaint, but I have little faith in anything (other than the most flagrant and obvious) resulting in action. My own belief is that if this was medicine, there'd be maimed and injured all over and the carnage caused by "the profession" would be difficult to hide. One can dream ... meanwhile, back to figuring out to file a pro se "motion to dismiss" as well as another court required paper that Indiana is so fond of providing NO resources for (unlike many other states, who don't automatically assume that citizens involved in the court process are scumbags) so that maybe I can get the family law attorney - whose work left me with no settlement, no possessions and resulted in the death of two pets (etc ad nauseum) - to stop abusing the proceedings supplemental and small claims rules and using it as a vehicle for harassment and apparently, amusement.

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