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Medicaid Class-Action Lawsuit

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There is a significant difference in the time required by law to process a Medicaid application and the actual time it takes to do so.  The Medicaid program is not just for the elderly, but also for low-income and disabled individuals.

A recent class-action lawsuit accuses the Maryland Department of Human Resources of breaking state law by taking up to a year to process Medicaid applications. The lawsuit claims to represent 10,000 disabled adults and was filed in mid-January of this year, in Baltimore Circuit Court seeking to force the department to make a decision on Medicaid applications within 60 days as required by law.

Many applicants have health problems, some of which are life threatening and are unable to obtain medical treatment outside of a hospital setting, until the application is processed and approved.  Some individuals cannot receive out-patient critical care and prescription drugs.

According to the state’s own report, as of December 31, 2012 there were 20,007 pending applications for MA-ABD statewide, meaning the state still had not processed and determined eligibility on these cases.  Of the pending cases, 9,940, almost half, were categorized as untimely due to “agency delay.”  Throughout all of 2012, the number of untimely pending cases never dropped below 8,300, indicating a severe and chronic backlog.  As cited in a Public Justice press release.

For those in need of long-term care assistance through Medicaid, they may be in the Nursing Home for six to eight months before the application is processed.  This can be difficult for the families and for the Skilled Nursing Facilities as it puts pressure on them to have paying customers. Legislation was introduced seeking, similarly to the current law suit, simply to have the department make determinations within the legal time limits prescribed by law.   The measure was held with the understanding that the department “was working on the problem.”   Let’s hope that this is the truth.

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