Texas Gray Panthers v. Shalala

, No. 99cv01557 (D.D.C. filed June 16, 1999) ; Clearinghouse Number: 52808

Description

Low-Income Elderly Plaintiffs Allege Inadequate Information, Counseling, and Assistance for Medicare Buy-In Program

Abstract

In this class action against Health and Human Services Secretary and Social Security Administration Commissioner, plaintiffs allege that defendants failed to implement explicit and mandatory provisions of the Medicare statute requiring defendants to establish a comprehensive plan of information, counseling, and assistance to ensure that low-income Medicare beneficiaries learn about the buy-in program and how to participate in it. The proposed class consists of all individuals who are or will be eligible for a Medicare buy-in program and who, for at least one month while they are or have been eligible, will not be or were not enrolled in a Medicare buy-in program. The Medicare buy-in program allows statutorily defined groups of low-income people to have Medicaid pay some or all of their financial obligations, such as premiums, deductibles, and coinsurance payments, to the Medicare program. Plaintiffs assert that, nearly a decade after Congress enacted the Medicare buy-in program, about 4.5 million people—over one-half of eligible individuals—are not participating and therefore continue to pay monthly Medicare premiums even though they are entitled to have the government pay those premiums. Plaintiffs allege that defendants do not target information to Medicare participants likely to be eligible; do not present information to eligible beneficiaries in an understandable and usable way; do not provide individual counseling or assistance; and do not supply uniform information about individuals likely to be eligible for the buy-in program to states as required by law. Challenging defendants’ failure to carry out these duties as agency action unlawfully withheld in violation of the Administrative Procedure Act and the due process clause of the Fifth Amendment, plaintiffs seek declaratory and injunctive relief.

Additional Information

Attorney Information
Plaintiff represented by Burton D. Fretz, Patricia Nemore, National Senior Citizens Law, 1101 14th St. NW, Suite 400, Washington, DC 20005 (202.289.6976); Keith R. Fentonmiller, Paul, Hastings, Janofsky & Walker, 1299 Pennsylvania Ave. NW, 10th Floor, Washington, DC 20004 (202.508.9500); Gill Deford, Center for Medicare Advocacy, P.O. Box 350, Willimantic, CT 06226 (860.456.7790).
Docket Date
1999-06-16 00:00:00+00:00

Files

Filed under: