Health Care

ACTIVE CASES

Fournier v. Sebelius (Ninth District, CA) – The law firm of Arnold & Porter submitted an amicus brief on behalf of NSCLC in support of a motion for rehearing and rehearing en banc in a Medicare case of potentially broad impact that could affect future litigation by NSCLC. More information.

Bagnall v. Sebelius – (D. Conn.) — This lawsuit, brought with lead counsel Center for Medicare Advocacy, challenges the Medicare program’s classification of hospital patients under “observation status.”  This classification denies beneficiaries of benefits they should be entitled to as hospital inpatients.  The litigation was filed Thursday November 3, 2011. More information.

Oster v. Lightbourne (formerly Oster v. Wagner)Filed in October, 2009, this class action lawsuit challenged the state of California’s budget-related cuts to the In-Home Supportive Services (IHSS) program, a Medicaid personal care services benefit that allows low-income older adults and persons with disabilities to stay at home and avoid institutionalization. Lawyers representing IHSS consumers, unions and the State of California reached a settlement in March 2013 that will prevent the implementation of devastating cuts to the state’s In-Home Supportive Services (IHSS) program.  For more details about the settlement, and to obtain the settlement class notice in additional languages, go to Disability Rights California’s website, www.disabilityrightsca.org, and click on the IHSS Settlement button.

Read the IHSS Settlement Class Notice

Read Settlement of IHSS Lawsuit Will Prevent Devastating Cuts to Home Care Services press release

Read Oster v. Wagner Complaint

Read Oster Order Granting Motion for Preliminary Injuction

Shuts v. Covenant Holdco LLC  (CA Court of Appeals).  The underlying lawsuit requests (among other things) that the court order the defendant nursing home chain to maintain adequate staffing levels in 19 California nursing homes.The National Senior Citizens Law Center, along with AARP,  submitted a friend of the court appellate brief February 24, 2012 supporting the right of nursing home residents to enforce California’s minimum nursing home staffing levels. More information.

Douglas v. Independent Living Center of Southern California (U.S. Supreme Court) — On Feb. 22, 2012, in a 5:4 decision, a Supreme Court majority refused to throw the case out of court. They sent the case back to the Court of Appeals for further consideration. The case revolves around the question: does federal law preempt state reductions in Medicaid payments. The state of California asked the Court to rule that Medicaid providers and beneficiaries do not have a cause of action for their claim that the slashing of reimbursement rates for prescription medications and other services was preempted. The dissenters would have dismissed the action. To read recent articles about the case, click here.

 

SETTLED CASES

The U.S. Supreme Court ruled on June 28, 2012 that the Affordable Care Act was constitutional and NSCLC provided a quick analysis of the decision. NSCLC was a leader in opposing the state challenges to the law.

Darling et al v. Douglas (Ninth District, California) — Filed in August, 2009.  On November 17, 2011, seven plaintiffs who represent a class of 35,000 low-income people with disabilities, including older adults, and the California Department of Health Care Services (DHCS) reached a settlement in a federal lawsuit that challenged the State’s planned elimination of Adult Day Health Care (ADHC) as a Medi-Cal benefit on December 1, 2011. Final approval from the court was granted on January 24, 2012. (Darling et al. v Douglas C:09-03798 SBA, formerly Cota et. al. v. Maxwell-Jolly).

Read Cota et. al. v. Maxwell-Jolly Complaint

Read Cota Order Granting Motion for Preliminary Injunction

Read Darling et al v. Douglas Order Granting Preliminary Approval of Settlement Agreement

Ledezma v. Shewry (California Superior Court, San Francisco) –Filed in February, 2007, this class action suit is on behalf of elderly and disabled Medi-Cal beneficiaries for whom the state has ceased paying Medicare premiums without cause or notice. While a settlement agreement seems to be near, it has not been finalized.

National Federation of Independent Businesses et al v Sebelius et al / State of Florida et al v DHHS et al (U.S. Supreme Court). In a joint Supreme Court friend of the court brief submitted on January 30, 2012, NSCLC argued that the provisions of the Affordable Care Act affecting those over age 65 should not be affected if the minimum coverage provision is found unconstitutional. NSCLC was joined by AARP, Center for Medicare Advocacy, Inc., Medicare Rights Center, National Committee to Preserve Social Security.

Commonwealth of Virginia, Ex Rel. Kenneth T. Cuccinelli, II v. Sebelius (U.S. District Court, Eastern Virginia) On June 17, 2010, attorneys from the Center for American Progress, the the National Senior Citizens Law Center, and PCT Law Group, PLLC, filed an amicus brief in support of the federal government’s Motion to Dismiss this case. The brief specifically addresses why the minimum coverage provisions of the law are indispensable to the long-sought prohibition on the exclusion of persons with preexisting conditions from health insurance plans.

U.S. Department of Health and Human Services et al v State of Florida, et al (U.S. Court of Appeals, 11th Circuit) In a Supreme Court amicus brief submitted January 11, 2012, NSCLC argued that the Affordable Care Act’s minimum coverage provision or individual mandate “falls squarely within Congress’ authority to regulate interstate commerce” and therefore is Constitutional.

Situ et al v. Leavitt (Ninth District)This action challenged the failure of the Secretary of the U.S. Department of Health and Human Services to protect dual eligible beneficiaries in its implementation of Medicare Part D. Under the agreement, the Secretary agreed to make significant changes to enrollment and deeming systems as well as to strengthen the safety net for new enrollees who are eligible for both Medicare and Medicaid.

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