Federal Court in nation-wide class action restores Medicaid benefits to dual eligibles

Health-Law-Announcements

We have exciting news from our colleagues at Disability Rights Connecticut, NHelp, Justice in Aging and their private co-counsel! They have a ruling in a nationwide class action to restore Medicaid benefits to individuals dually eligible for Medicaid and Medicare whose benefits were reduced after March 18, 2020 to only the Medicare Savings program despite a federal statute prohibiting loss of Medicaid benefits. This was a nationwide class action that will apply to  Massachusetts. MassHealth implemented the unlawful federal regulation from  July, 2021 through July, 2022 by reducing benefits for certain dually eligible elderly and disabled individuals  from MassHealth Standard to only Medicare Savings benefits (the Buy-In and Senior Buy-In programs). The court has now ruled the federal regulation MassHealth was following was unlawful, and ordered CMS to notify states by Feb 7, 2023.

 

Federal Judge Issues Nationwide Injunction, Restoring Vital Medicaid Benefits for Older Adults and People with Disabilities

In a significant victory for older adults and people with disabilities, a federal judge in the U.S. District Court for the District of Connecticut yesterday issued a nationwide preliminary injunction in the class action case of Carr v. Becerra. This ruling orders the U.S. Department of Health and Human Services to stop enforcing an illegal Trump-era Interim Final Rule (IFR) that stripped vital Medicaid benefits away from hundreds of thousands of low-income individuals protected by law against loss of Medicaid coverage during the COVID public health emergency.

 

As a result of this decision, states must promptly reinstate benefits to all individuals who have lost them since March 18, 2020 or risk losing substantial federal Medicaid funding. These individuals will also remain on Medicaid during the “unwinding” when the pandemic-era funding program begins to end, a process that starts on April 1, 2023. This unwinding process requires state Medicaid programs to fully evaluate whether individuals kept on Medicaid due to the pandemic might still be eligible before terminating their coverage. The injunction means that thousands who were already improperly cut off will also get the benefit of this careful review prior to termination, and advocates believe many of these people will then be found to be eligible for continued Medicaid coverage. The injunction will ensure continued access to vital benefits without interruptions in care or services.

 

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