NCLEJ Sues New Hampshire for Failing to Pay Full Medical Costs

Capps v. Toumpas challenges New Hampshire’s policy of refusing to reimburse Medicaid recipients who receive Medicaid through the Aid to the Permanently and Totally Disabled program for the full amount of their prescription medication expenses incurred from the date of their application until the date they receive their Medicaid card following a favorable eligibility decision on appeal. The class action complaint was filed by New Hampshire Legal Assistance and NCLEJ on November 23, 2009, in the United States District Court for the District of New Hampshire.

If the case is successful, the named plaintiff will receive approximately $3,500, the amount he spent on prescriptions while awaiting his administrative appeal decision, that has not been reimbursed. The State reimbursed his expenses at the Medicaid rate, even though his out-of-pocket expenses exceeded the Medicaid rate amount because he was forced to pay the higher rate while awaiting his favorable appeal decision. A favorable outcome in this case will provide similar help to many other persons with disabilities in New Hampshire.

For further information, contact Laura Redman, redman (at)