Healey v. Thompson

No. 3:98cv418(DJS) (D. Conn. Sept. 21, 2001); Clearinghouse Number: 52263

Description

Medicare Recipients Sue Department of Health and Human Services for Failing to Give Home Health Service Beneficiaries Written Notice of Terminations

Abstract

Plaintiffs—elderly and disabled Medicare beneficiaries whose home health services were reduced or terminated—filed a class action suit challenging defendant Secretary of the U.S. Department of Health and Human Services’ practice of reducing and terminating home health services without written notice. Each of the nine named plaintiffs suffers from a variety of chronic disabilities, and their physicians prescribed skilled nursing visits, physical therapy, and home health aide care for each of them. Such services are covered under the Medicare statute and are provided by home health agencies under contract with the federal Medicare administration. Plaintiffs allege that, although coverage rules have not changed, changes in reimbursement rules caused the home health agencies to deny, terminate, or severely reduce services to heavy-care patients. Also, they claim that because home health services enable plaintiffs to stay at home, the terminations and reductions threaten to force them into nursing homes. Plaintiffs allege that defendant, despite the written-notice requirement in Medicare manuals, the Medicare statute, 42 U.S.C. §§ 1395 et seq. and their regulations, 42 C.F.R. § 484.10(1) and (2), and the due process clause of the Fifth Amendment of the U.S. Constitution, failed to enforce the notice requirement and failed to require the agencies to give adequate written notice to beneficiaries. Plaintiffs ask the court to order the Department of Health and Human Services to enforce the written denial notice requirements, to establish an expedited pretermination hearing process for home health appeals, and to provide the care necessary pending the expedited decision.

Additional Information

Attorney Information
Docket Date
2001-09-21 05:00:00+00:00

Files

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