Ohio settles lawsuit brought by group over termination of some Medicaid recipients' benefits

Associated Press

About 154,000 Ohio residents will have their Medicaid health benefits restored and their eligibility for the program rechecked as part of a settlement reached in a lawsuit against the state, the Department of Medicaid said Tuesday.

The agreement comes in a case involving how Ohio officials "re-determine" the eligibility of recipients in the federal-state health program for the poor and disabled.

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In late March, the Legal Aid Society of Columbus sued the state'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. They claimed that some individuals' Medicaid benefits were terminated or put at risk after Ohio failed to follow federal law and Medicaid regulations during the review process.

Among other issues, the legal group had argued that the state failed to conduct certain Medicaid renewal procedures and did not adequately notify recipients as to why coverage was being terminated and how to appeal it.

Federal law requires states to "re-determine" annually whether recipients remain eligible for Medicaid. Beneficiaries have their eligibility reviewed the same month they enrolled the previous year.

The latest state figures show that at least 153,743 recipients were dropped from Medicaid during the first three months of the year.

The settlement agreement restores the health benefits of those terminated from the program in January, February and March, the state's Medicaid department said. Ohio has until Aug. 1 to put them back on the program and then individuals will have their eligibility checked again. The agreement does not apply to certain residents who have submitted renewal information to the state and were found not eligible for the program.

A spokesman for the Ohio Department of Medicaid said the settlement allows Ohio to continue the monthly eligibility checks as required by federal law.

"We're happy to have been able to work through these issues in an expedient manner and reach an agreement with the plaintiffs," Ohio Medicaid spokesman Sam Rossi said in a written statement.

The settlement also directs Ohio Medicaid to make a good-faith effort to promote renewing for Medicaid online or over the phone. The state also must provide renewal documents in Spanish and Somali, which had been in the works.

Last month, U.S. District 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 benefits 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 started the "passive" process in April.

Medicaid provides health coverage to nearly one out of every four Ohioans.