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. Indiana's seatbelt law is not punishable as a crime. It is an infraction. Apparently some of our Circuit judges have deemed settled law inapplicable if it fails to fit their litmus test of political correctness. Extrapolating to redefine terms of behavior in a violation of immigration law to the entire body of criminal law leaves a smorgasbord of opportunity for judicial mischief.

  2. I wonder if $10 diversions for failure to wear seat belts are considered moral turpitude in federal immigration law like they are under Indiana law? Anyone know?

  3. What a fine article, thank you! I can testify firsthand and by detailed legal reports (at end of this note) as to the dire consequences of rejecting this truth from the fine article above: "The inclusion and expansion of this right [to jury] in Indiana’s Constitution is a clear reflection of our state’s intention to emphasize the importance of every Hoosier’s right to make their case in front of a jury of their peers." Over $20? Every Hoosier? Well then how about when your very vocation is on the line? How about instead of a jury of peers, one faces a bevy of political appointees, mini-czars, who care less about due process of the law than the real czars did? Instead of trial by jury, trial by ideological ordeal run by Orwellian agents? Well that is built into more than a few administrative law committees of the Ind S.Ct., and it is now being weaponized, as is revealed in articles posted at this ezine, to root out post moderns heresies like refusal to stand and pledge allegiance to all things politically correct. My career was burned at the stake for not so saluting, but I think I was just one of the early logs. Due, at least in part, to the removal of the jury from bar admission and bar discipline cases, many more fires will soon be lit. Perhaps one awaits you, dear heretic? Oh, at that Ind. article 12 plank about a remedy at law for every damage done ... ah, well, the founders evidently meant only for those damages done not by the government itself, rabid statists that they were. (Yes, that was sarcasm.) My written reports available here: Denied petition for cert (this time around): http://tinyurl.com/zdmawmw Denied petition for cert (from the 2009 denial and five year banishment): http://tinyurl.com/zcypybh Related, not written by me: Amicus brief: http://tinyurl.com/hvh7qgp

  4. Justice has finally been served. So glad that Dr. Ley can finally sleep peacefully at night knowing the truth has finally come to the surface.

  5. While this right is guaranteed by our Constitution, it has in recent years been hampered by insurance companies, i.e.; the practice of the plaintiff's own insurance company intervening in an action and filing a lien against any proceeds paid to their insured. In essence, causing an additional financial hurdle for a plaintiff to overcome at trial in terms of overall award. In a very real sense an injured party in exercise of their right to trial by jury may be the only party in a cause that would end up with zero compensation.

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