NCLEJ Settles Lawsuit Against Florida State Medicaid Agencies for Unlawfully Terminating Healthcare Benefits for Eligible Individuals
OnFebruary 25, NCLEJ and its partners secureda settlement agreement with Florida’s state Medicaid agencies to ensure thateligible individuals, including many with disabilities, can keep accessing health care services withoutinterruption.
OnAugust 8, 2019 NCLEJ joined with partners to file a lawsuit againstFlorida’s Department of Children andFamilies (DCF) and Agency for Health Care Administration (AHCA), on behalf of aclass of thousands who have lost or will lose access to Medicaid coverage dueto these agencies’ wrongful termination of their health benefits. Class membersreceived Medicaid as part of either an adoption assistance agreement with thestate or their receipt of federal disability benefits (SSI). But when theseindividuals transitioned out of these programs, Florida’s agencies repeatedlyfailed to conduct timely reviews for continued Medicaid eligibility under othercategories, and failed to provide timely notification of their termination fromMedicaid, resulting in dangerous gaps in health coverage for people who rely onMedicaid to fill prescriptions, see their doctors, and continue gettingtreatment.
Pursuant to the settlement agreement,DCF has to develop a system to ensure reviews are conducted before strippingMedicaid from those aging out of adoption assistance benefitsand forindividuals with disabilities whose federal Supplemental Security Income isterminated. Additionally, DCF will have to provide staff training for thoseconducting eligibility reviews, update its guidance materials, implementcorrective action for those affected, and modify its notices of Medicaidtermination. The notices must now include the date of Medicaid termination forthose losing SSI benefits and a statement regarding DCF’s obligation to providenotice to individuals ten days before terminating Medicaid benefits.
U.S. District Judge Brian J. Davis ofthe Middle District of Florida agreed to retain jurisdiction to enforce theterms of the settlement agreement for one year from the date of the executedagreement.
When implemented, thisagreement will result in a fair assessment of Medicaid eligibility and enable thousands of individuals to continue accessing critical health care serviceswithout needless interruption.
NCLEJ worked with Jacksonville Area Legal Aid, the Florida Health Justice Project, and Disability Rights Florida on the case. Read our full press release here.