Judge orders Ohio officials to reinstate Medicaid health benefits for individuals in lawsuit

Associated Press

A federal judge ordered Ohio officials on Thursday to reinstate Medicaid benefits for people in a lawsuit but denied a request to expand such relief to tens of thousands of others being terminated from the program.

The decision comes in a case involving how the state's Medicaid agency "re-determines" the eligibility of recipients in the federal-state program.

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The Legal Aid Society of Columbus has sued Ohio's Medicaid director on behalf of several individuals and two nonprofits in central Ohio: the Community Refugee and Immigration Services and Community Development for All People.

The lawsuit claims that the Medicaid benefits of the five plaintiffs and individuals served by the nonprofits were either terminated or put at risk after the state failed to follow federal law and Medicaid regulations. Among other issues, the legal group argues that the state failed to conduct certain Medicaid procedures and did not adequately notify recipients as to why coverage was being terminated and how to appeal it.

Judge Algenon Marbley ordered Ohio to reinstate benefits for individuals in the case and those members identified by the plaintiff organizations as dropped from Medicaid or at risk of losing it based on the state's procedures. The judge also temporarily blocked the state from terminating the coverage of members belonging to the two organizations unless officials adopt certain practices such as using more detailed termination notices and instituting a "passive" re-determination process in accordance with federal law.

The state has said it recently started the "passive" process for those whose eligibility is up in May.

"We respect the court's decision and are in the process of complying with the order," Ohio Medicaid spokesman Sam Rossi said Thursday.

Marbley said the plaintiff organizations lacked standing to seek similar relief on behalf of Medicaid recipients who aren't their members but whose benefits are at risk or terminated.

In February, the state sent more than 66,000 notices to Medicaid recipients informing them their coverage would stop March 1, according to a court filing from the legal group. An additional 83,000 notices went out in early March telling residents their coverage would be terminated April 1.

Kate McGarvey, an attorney for the Legal Aid Society of Columbus, said she was pleased with the order.

"We are going to continue to work on this issue until everyone gets the protection of the federal rules," she added.

Marbley has scheduled an April 15 hearing on the group's request for a longer order.