Favorable Decision for New York Medicaid Recipients

On March 4, 2016, the U.S. District Court issued an important decision in Fishman v. Daines in favor of low-income elderly and disabled New York Medicaid recipients who seek fair hearings to challenge New York State’s termination of their Medicaid. The problem arose because many disabled and/or elderly Medicaid recipients do not receive the appointment that schedules the fair hearing. Yet, when the recipient misses the fair hearing, her Medicaid is terminated without further notice. The plaintiffs claim that termination without such a post-default notice violates both due process and the Medicaid Act.

The District Court preliminarily enjoined the New York State Office of Temporary and Disability Assistance and the New York State Department of Health from dismissing such appeals unless the recipient is given at least 10 days to respond to a written notice asking whether they want their hearing rescheduled. This win will impact hundreds of New York Medicaid recipients each year.

Earlier, the District Court had ruled against the plaintiffs, but, on appeal, the Second Circuit set aside that decision and sent the case back to the District Court for further consideration. NCLEJ filed a friend-of-the-court brief in the Second Circuit in support of the Medicaid recipients who brought the case.