Groups Challenge Ariz. Medicaid Agency’s Reductions of Health Care Benefits for Immigrants

Groups Challenge Ariz. Medicaid Agency’s Reductions of Health Care Benefits for Immigrants

William E. Morris Institute for Justice and NHeLP Urge Federal Court to Order State Officials to Restore Health Services

Washington – The William E. Morris Institute for Justice and the National Health Law Program (NHeLP), filed a lawsuit this week, in the U.S. District Court in Tucson, representing two plaintiffs and a class of similarly situated persons, alleging the Arizona Health Care Cost Containment System (AHCCCS) violated the Medicaid Act when it reduced benefits for immigrants eligible for full-scope health care benefits to emergency-only benefits when the immigrants renewed/recertified for benefits. Plaintiffs and the class (Darjee v. Betlach) also challenge the eligibility notice AHCCCS sends to immigrants that informs them of their eligibility for emergency-only benefits as violating the Medicaid Act and constitutional due process.

Under federal and state law, certain qualified immigrants are eligible for full-scope Medicaid while other immigrants are eligible for Federal Emergency Services (FES) or emergency-only AHCCCS. Plaintiffs allege that for at least the last 18 months, AHCCCS and its agent the Arizona Department of Economic Security (DES) have improperly transferred immigrants entitled to full-scope AHCCCS to emergency-only AHCCCS in violation of the federal Medicaid Act. AHCCCS is responsible for the actions of DES.

Plaintiffs allege that as a result of the improper transfers, eligible state Medicaid participants with significant medical conditions, including persons with diabetes, mental health conditions, asthma and high blood pressure; have been left without needed medical care. Plaintiffs also allege that as a result of the improper transfers, Medicaid-eligible persons cannot fully participate in the AHCCCS Medicaid program and their health is being adversely affected.

Finally, Plaintiffs allege that the notices AHCCCS sends out informing the persons that they are only eligible for emergency services violate the Medicaid Act and due process.

The lawsuit claims that the unlawful reduction in medical eligibility is caused by the computer programming and caseworker errors. Plaintiffs also allege that plaintiffs’ counsel informed AHCCCS about the improper transfers last October. Plaintiffs allege that since then more than 3,500 immigrants have had their medical benefit restored but the improper transfers continue and now some persons have had their benefits reduced for a second time in a year. Plaintiffs allege that while full AHCCCS provides comprehensive care for eligible persons, emergency only AHCCCS provides significantly more limited coverage care limited to situations that come about suddenly and could cause serious harm. Plaintiffs allege that medications and doctor appointments are not covered by emergency only services.

Ellen Katz, Litigation Director for the Institute stated, “The U.S. allows refugees and other immigrants to enter the U.S. for humanitarian reasons. These persons often have language and cultural barriers. We claim AHCCCS has failed in its obligation to process the immigrants’ renewal for medical benefits according to the requirements of the Medicaid Act and used eligibility notices that lacked meaningful information so the recipients could understand the notices.”

“These drastic reductions in Medicaid services are unwarranted and unjust,” NHeLP Staff Attorney Cori Racela said. “Arizona Medicaid officials are running afoul of Medicaid rules, jeopardizing the health of scores of qualified beneficiaries. We are urging the federal court to ensure that Arizona Medicaid officials correct course and restore vital health care services.”

For more information, contact Ellen Katz at (602) 252-3432 or Jeremy Leaming at leaming@healthlaw.org or (202) 552-5176.

Founded in 1969 NHeLP advocates for the rights of low-income and underserved people to access quality health care.

The Morris Institute for Justice is a non-profit law program that works on issues of importance to low-income Arizonans.

Related Content

For almost 50 years, the National Health Law Program has fought to expand access to quality health care to low-income individuals and underserved communities. Today we are pleased to launch a newly designed website for our future work to make health care a reality for all people. Please take time to peruse our new site, and sign up for our email updates to learn about us, watch the work we do, and become engaged.

Continue to site