A U.S. district court rules that a group of Medicaid applicants do not have a private right of action to sue the state for not issuing Medicaid eligibility determinations with 45 days and that the applicants were not denied due process by the delay. Evangelical Lutheran Good Samaritan Society, Inc. v. Randol (U.S. Dist. Ct., D. Ks., No. 16-CV-2665-DDC-GEB, July 20, 2017).
Twenty-one residents of a Kansas nursing home applied for Medicaid, and the state did not issue an eligibility determination within 45 days. Eventually, the state approved 10 applications and denied nine, while two applications are still pending.
The Medicaid applicants and the nursing home sued the state, arguing, among other things, that the state violated their due process rights and the federal law requiring states to make a timely determination of Medicaid eligibility. Medicaid's implementing regulations, 42 C.F.R. 435.912(c)(3), require the state to make an eligibility determination within 45 days. The state filed a motion to dismiss.
The U.S. District Court, District of Kansas, grants the motion to dismiss, holding that the applicants have not stated a claim upon which relief may be granted. According to the court, the applicants do not have a constitutionally protected interest in Medicaid benefits and have not alleged the state denied them any due process. The court also rules that the Medicaid implementing regulation requiring a timely Medicaid eligibility determination does not create an individual right enforceable through a private cause of action.
For the full text of this decision, go to: https://ecf.ksd.uscourts.gov/cgi-bin/show_public_doc?2016cv2665-27
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