Health Care

ACTIVE CASES

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.

Douglas v. Independent Living Center of Southern California (U.S. Supreme Court) — The case revolves around the question: does federal law preempt state reductions in Medicaid payments. The state of California is asking 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. Oral arguments were heard in October 2011. To read recent articles about the case, click here.

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 (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

Oster v. Wagner, Ninth Circuit, California — Filed in October, 2009, this proposed class action lawsuit challenges 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. The Ninth Circuit has indicated it will not issue its decision until the Supreme Court has ruled in Douglas v. Independent Living Center of Southern California.

Read Oster v. Wagner Complaint

Read Oster Order Granting Motion for Preliminary Injuction

• Read Defendant’s Certification of Compliance with Preliminary Injunction
• Read Notice to IHSS Consumers

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.

SETTLED CASES

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.