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. This is ridiculous. Most JDs not practicing law don't know squat to justify calling themselves a lawyer. Maybe they should try visiting the inside of a courtroom before they go around calling themselves lawyers. This kind of promotional BS just increases the volume of people with JDs that are underqualified thereby dragging all the rest of us down likewise.

  2. I think it is safe to say that those Hoosier's with the most confidence in the Indiana judicial system are those Hoosier's who have never had the displeasure of dealing with the Hoosier court system.

  3. I have an open CHINS case I failed a urine screen I have since got clean completed IOP classes now in after care passed home inspection my x sister in law has my children I still don't even have unsupervised when I have been clean for over 4 months my x sister wants to keep the lids for good n has my case working with her I just discovered n have proof that at one of my hearing dcs case worker stated in court to the judge that a screen was dirty which caused me not to have unsupervised this was at the beginning two weeks after my initial screen I thought the weed could have still been in my system was upset because they were suppose to check levels n see if it was going down since this was only a few weeks after initial instead they said dirty I recently requested all of my screens from redwood because I take prescriptions that will show up n I was having my doctor look at levels to verify that matched what I was prescripted because dcs case worker accused me of abuseing when I got my screens I found out that screen I took that dcs case worker stated in court to judge that caused me to not get granted unsupervised was actually negative what can I do about this this is a serious issue saying a parent failed a screen in court to judge when they didn't please advise

  4. I have a degree at law, recent MS in regulatory studies. Licensed in KS, admitted b4 S& 7th circuit, but not to Indiana bar due to political correctness. Blacklisted, nearly unemployable due to hostile state action. Big Idea: Headwinds can overcome, esp for those not within the contours of the bell curve, the Lego Movie happiness set forth above. That said, even without the blacklisting for holding ideas unacceptable to the Glorious State, I think the idea presented above that a law degree open many vistas other than being a galley slave to elitist lawyers is pretty much laughable. (Did the law professors of Indiana pay for this to be published?)

  5. Joe, you might want to do some reading on the fate of Hoosier whistleblowers before you get your expectations raised up.