Federal judge rules against Indiana’s Medicaid provider in disability services dispute
INDIANAPOLIS (WISH) — A federal judge on Tuesday said the state’s Medicaid agency likely violated federal law when it forced families of medically complex children off the attendant care program.
The order from Judge Tanya Wilson Pratt is the latest twist in the monthslong fight over eligibility for the attendant care program.
The Family and Social Services Administration (FSSA) on July 1 ended parents’ eligibility for the attendant care program, which provides hourly reimbursement for providing extraordinary levels of care for people with severe medical needs. Parents must instead designate someone else as a legally responsible person for their child, institutionalize them, or enroll in the structured family caregiving program, which provides a daily stipend that is a fraction of the attendant care rate.
Ruling in favor of two mothers whose children require 24/7 care, Pratt wrote, the FSSA likely violated the Americans with Disabilities Act’s integration mandate, which prohibits the unnecessary segregation of people with disabilities.
“Here, there is substantial evidence that the Individual Plaintiffs would be forced into institutionalized care unless their parents are able to secure ATTC (Attendant Care) reimbursement, or alternatively, FSSA ensures the provision of home nursing services,” she wrote. “(Plaintiffs are) likely to succeed on the merits of their integration mandate claims.”
Despite this, Pratt wrote, it is not possible to block the FSSA’s changes entirely because “it could result in irreparable harm to FSSA should they rewrite the H&W (Health and Wellness) Waiver and later succeed in this case.”
Pratt concluded by writing she will grant the families’ request for an order blocking the FSSA’s changes, but the families must modify their request.
She ordered the FSSA to immediately arrange for the delivery of corrective skilled nursing services to the two families and to simultaneously reimburse the mothers under the structured family caregiving program.
Medicaid, the federal-state health care insurance program, helps pay for health care for low-income people of any age. Coverage varies by state; each state determines eligibility and the full scope of services covered. The federal government reimburses a percentage of the state’s expenditures.