Federal Judge Issues Order Requiring State Health Officials to Stop Limiting Medical Services to Recipients Under Medicaid and the ADA
Washington – A federal judge in New York issued an order today enjoining state health officials from limiting coverage of necessary medical care for some state Medicaid beneficiaries. The Empire Justice Center and the National Health Law Program (NHeLP) represented recipients who had been denied medically necessary orthopedic footwear and compression stockings. The groups argued that the state’s elimination of certain orthopedic services violated the rights of Medicaid beneficiaries and individuals with disabilities, pursuant to Medicaid law and the Americans with Disabilities Act.
The group of plaintiffs in Davis v. Shah had challenged state officials’ elimination of coverage for orthopedic benefits. The order today bars the state from enforcing policy that limited access to those health care needs. Many beneficiaries without such access to medically necessary accoutrements would likely have to leave their communities for institutions.
Empire Justice Center Attorney Geoffrey Hale welcomed the decision, but noted that patients need to quickly learn of the court’s decision so they can access the medical care they need to remain in their communities.
“Patients should be aware that if their doctors say they need specific orthopedic care, such as footwear and compression stockings that they can now seek coverage of them as medically necessary services, regardless of whether their specific diagnosis is recognized by state health officials,” said Hale.
NHeLP Legal Director Jane Perkins said, “Our clients wanted to be able to live and interact in their communities. Today’s ruling recognizes the importance of the Medicaid Act and the Americans with Disabilities Act in ensuring that they can do so.”
U.S. District Court Judge Charles J. Siragusa for the Western District of New York issued the order and declaratory and permanent injunctive relief today, which states, in part, that the New York State Department of Health officials and contractors are “permanently enjoined from enforcing” the previous June 2011 policy that limited the types of orthopedic care for Medicaid recipients and certain individuals with disabilities. The state Medicaid agency agreed to entry of the Order.
Founded in 1969 NHeLP advocates for the rights of low-income and underserved people to access quality health care.
Empire Justice Center is a statewide, multi-issue, multi-strategy, public interest law firm focused on changing the “systems” within which poor and low-income families live. Empire Justice protects and strengthens the legal rights of people in New York State who are poor, disabled or disenfranchised through: systems change advocacy, training and support to other advocates and organizations, and high quality direct civil legal representation. Empire Justice has five offices in Albany, Rochester, Yonkers, White Plains and Central Islip on Long Island.