Lawsuit accuses Florida of ‘illegal’ Medicaid terminations [Orlando Sentinel]

Three Florida residents are suing the state’s Agency For Healthcare Administration and Department of Children and Families, alleging the public health insurance program for low-income and disabled people sent out illegal termination notices.

A class-action lawsuit was filed Tuesday on behalf of a mom, her 2-year-old daughter and a 1-year-old by the National Health Law Program and Florida Health Justice Project. The suit alleges that Florida violated the Medicaid Act and the U.S. Constitution’s Due Process Clause by failing to give adequate notification to people losing coverage, and failing to give them a shot at appealing.

The Due Process Clause has been interpreted by the U.S. Supreme Court as requiring “prior notice and a meaningful opportunity to be heard when an individual is in jeopardy of losing benefits,” according to the National Health Law Program.

The notices provided to families were vague and at times contradictory, the suit alleges. Some people were told they had exceeded income limits but weren’t told Medicaid’s limits or how much DCF determined they made. Others were told they were losing Medicaid, but they were given a reason that had nothing to do with why they were ineligible.

The mom of the 1-year-old named in the suit didn’t realize that the toddler was losing coverage until after her pediatrician told her that her child no longer had health insurance. She didn’t understand how to appeal, the suit states.

“People don’t know that the reason for termination might be incorrect, that DCF was using the wrong information or they made a wrong determination. They don’t know that they ought to challenge it,” said Miriam Harmatz, founder and director of advocacy for the Florida Health Justice Project.

Some Floridians in limbo over Medicaid coverage loss

More than 182,000 Floridians have been issued notices saying they are no longer eligible for coverage since April, after the end of a COVID-era policy that banned states from dropping people from the program for low-income children, families and young adults, even if they became ineligible.

This is the first lawsuit amid the nationwide Medicaid unwinding.

“The scope of terminations in Florida and the State’s knowledge of inadequate notices are certainly egregious. Unfortunately, similar patterns are happening in states across the country,” said Amanda Avery, senior attorney at the National Health Law Program, in a news release.

The problem stretches far beyond the three people used as examples in the suit, Harmatz said.

The suit shares that Florida has known for years that their Medicaid termination notices are flawed. In a 2018 case study of the state’s termination process, state officials reported “being well aware that notices sent to beneficiaries generate confusion” and that the “current notices that describe applicants as ineligible are considered to be not sufficiently explicit in terms of an explanation.”

The lawsuit is asking that people who received “unconstitutional” notices regain Medicaid coverage until they are given new notices, with enough information to understand how and if they can appeal, Harmatz said.

People can request an appeal within 90 days of their termination notice. If an appeal is requested before someone’s Medicaid coverage is set to end, they can continue to receive benefits at least until a hearing is completed.

Appeals can be most easily requested by calling DCF, mailing a request, submitting an online request for a public assistance hearing on DCF’s website or sending an email to appeal.hearings@myflfamilies.com. That information is not included in termination notices, the suit states.

Harmatz believes that the plaintiffs in this suit are still eligible for Medicaid assistance and were mistakingly terminated.

Over the last few months, Florida has faced criticism for actions including taking away sick kids’ coverage months before they were scheduled to undergo review, according to the state’s own prioritization plan.

Florida is taking sick kids off Medicaid months before planned

This suit does not address those issues, Harmatz said.

“We’re not asking the court to order the state to follow its plan. We’re just asking the court to order the state to no longer use notices that violate the Constitution and the Medicaid Act.”

The Orlando Sentinel contacted DCF and AHCA for comment. This article will be updated if they provide responses.

Ccatherman@orlandosentinel.com; @CECatherman Twitter

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