Medicaid applications review policy doesn't violate federal law

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An administrative law judge’s refusal to consider evidence of conditions that aren’t disclosed on a Medicaid disability application doesn’t violate federal law and the Due Process Clause, a majority on the Indiana Court of Appeals ruled today.

The judges disagreed in Anne Walterman Murphy, et al. v. William Curtis, et al.  No. 49A04-0909-CV-503, about whether the trial court was correct in granting summary judgment for a class of Medicaid applicants who were denied benefits. The applicants had originally applied for benefits citing one condition and were denied. They then reapplied based on other conditions and at their hearing before an administrative law judge, tried to present evidence on the conditions in the denied applications.

Judges Paul Mathias and Cale Bradford reversed summary judgment in favor of the class and ordered summary judgment entered for the state. They didn’t find the Family and Social Services Administration’s interpretation of the applicable statutes and regulations to be unreasonable, violative of any of the cited statutes or regulations, or constitute denial of due process.

The majority noted that the de novo hearing by the ALJ provided for under Indiana Code Section 12-15-28-4 doesn’t allow for the applicant or county office to introduce additional evidence at the hearing that is unrelated to the conditions in the application being reviewed.

“Furthermore, simply because due process and the applicable regulations require a de novo hearing does not mean that the scope of the hearing must be expanded to include every possible condition that the applicant claims could result in benefits,” wrote Judge Mathias. “A de novo hearing does not require the consideration of materials unrelated to the issue appealed. Otherwise, the need for an initial application and review by the (Medicaid Medical Review Team) would be essentially superfluous.”

Judge Patricia Riley dissented because she believes the current policy used by the ALJ excluding any evidence not alleged in the original application, but that which could establish the applicant is entitled to benefits, violates the basic notions of due process and also an ALJ’s duty in inquire.

“…I conclude that the ALJ’s duty of inquiry is not suspended when the applicant fails to list a particular disability in his or her application or raises it for the first time during the administrative hearing; rather, an ALJ is obligated to investigate the disabling effects of each possible impairment suggested by the record and which may be relevant in order to reach an informative conclusion as to whether the applicant is eligible to receive assistance,” she wrote. “Today’s majority decision falls well short of this goal.”


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  1. I think the cops are doing a great job locking up criminals. The Murder rates in the inner cities are skyrocketing and you think that too any people are being incarcerated. Maybe we need to lock up more of them. We have the ACLU, BLM, NAACP, Civil right Division of the DOJ, the innocent Project etc. We have court system with an appeal process that can go on for years, with attorneys supplied by the government. I'm confused as to how that translates into the idea that the defendants are not being represented properly. Maybe the attorneys need to do more Pro-Bono work

  2. We do not have 10% of our population (which would mean about 32 million) incarcerated. It's closer to 2%.

  3. If a class action suit or other manner of retribution is possible, count me in. I have email and voicemail from the man. He colluded with opposing counsel, I am certain. My case was damaged so severely it nearly lost me everything and I am still paying dearly.

  4. There's probably a lot of blame that can be cast around for Indiana Tech's abysmal bar passage rate this last February. The folks who decided that Indiana, a state with roughly 16,000 to 18,000 attorneys, needs a fifth law school need to question the motives that drove their support of this project. Others, who have been "strong supporters" of the law school, should likewise ask themselves why they believe this institution should be supported. Is it because it fills some real need in the state? Or is it, instead, nothing more than a resume builder for those who teach there part-time? And others who make excuses for the students' poor performance, especially those who offer nothing more than conspiracy theories to back up their claims--who are they helping? What evidence do they have to support their posturing? Ultimately, though, like most everything in life, whether one succeeds or fails is entirely within one's own hands. At least one student from Indiana Tech proved this when he/she took and passed the February bar. A second Indiana Tech student proved this when they took the bar in another state and passed. As for the remaining 9 who took the bar and didn't pass (apparently, one of the students successfully appealed his/her original score), it's now up to them (and nobody else) to ensure that they pass on their second attempt. These folks should feel no shame; many currently successful practicing attorneys failed the bar exam on their first try. These same attorneys picked themselves up, dusted themselves off, and got back to the rigorous study needed to ensure they would pass on their second go 'round. This is what the Indiana Tech students who didn't pass the first time need to do. Of course, none of this answers such questions as whether Indiana Tech should be accredited by the ABA, whether the school should keep its doors open, or, most importantly, whether it should have even opened its doors in the first place. Those who promoted the idea of a fifth law school in Indiana need to do a lot of soul-searching regarding their decisions. These same people should never be allowed, again, to have a say about the future of legal education in this state or anywhere else. Indiana already has four law schools. That's probably one more than it really needs. But it's more than enough.

  5. This man Steve Hubbard goes on any online post or forum he can find and tries to push his company. He said court reporters would be obsolete a few years ago, yet here we are. How does he have time to search out every single post about court reporters and even spy in private court reporting forums if his company is so successful???? Dude, get a life. And back to what this post was about, I agree that some national firms cause a huge problem.