A federal district court rules that nursing homes acting as authorized representatives for residents whose Medicaid applications were denied do not have standing to sue the state on the residents' behalf. Communicare, LLC v. Dungey (U.S. Dist. Ct., S.D. Ohio, No. 2:17–cv–934, April 12, 2018).
Three nursing home residents in three different Ohio nursing homes applied for Medicaid. The residents were all incapacitated, and the nursing homes acted as their designated representatives. The authorized representative forms empowered the nursing homes to initiate an application for Medicaid benefits and take action necessary to establish eligibility for Medicaid. The state denied all three Medicaid applications.
The nursing homes sued the state on behalf of the residents, alleging that the state violated Medicaid law when it denied the applications. The state filed a motion to dismiss, arguing that the nursing homes did not have standing as authorized representatives.
The U.S. District Court, Southern District of Ohio, grants the motion to dismiss, holding that the authorized representatives do not have authority to sue on behalf of the residents. According to the court, this lawsuit did not fit into any of the categories on the authorized representative forms because the residents are "seeking neither review, nor a determination of their Medicaid benefits" and are instead "alleging civil rights violations caused by the alleged improper denial of the Medicaid benefits."
For the full text of this opinion, go to: https://law.justia.com/cases/federal/district-courts/ohio/ohsdce/2:2017cv00934/207505/23/
Did you know that the ElderLawAnswers database now contains summaries of more than 2,000 fully searchable elder law decisions dating back to 1993? To search the database, click here.
Subscribe to the Knowledge Bank.
