FRANKFORT, Ky. (Aug. 10, 2004) - U.S. District Judge Joseph M. Hood today approved a settlement agreement between the Cabinet for Health and Family Services and plaintiffs concerning a lawsuit filed in 2003 over Medicaid benefits.
Under the settlement, the cabinet agreed to re-instate or re-evaluate hundreds of Medicaid recipients whose long-term care services were terminated or denied based on a change in regulations in April 2003.
"This settlement reflects the efforts Governor Ernie Fletcher and this cabinet have been making since January," said Dr. James W. Holsinger Jr., secretary of the Cabinet for Health and Family Services. "We’re very pleased with this agreement and glad we could fix the problems for this vulnerable population."
Governor Fletcher announced in January he was rolling back the regulations that had caused the Medicaid recipients to lose their coverage. However, there were still some problems and attorneys for the plaintiffs brought them to the cabinet’s attention.
Between April 4, 2003, and May 16, 2004, there were approximately 3,505 adverse determinations. However, because there was some duplication of cases among those determinations, less than 3,505 people were affected.
Under a new regulation that was included in the settlement agreement, Medicaid recipients will have to meet two of 12 criteria that are used to determine eligibility for services.
The cabinet also agreed to a monitoring system in which the cabinet will provide information about the recipients for a two-year period to make sure the terms are complied with.
During a hearing today in Lexington, Judge Hood commended the administration and the attorneys who worked on the case on behalf of the cabinet and the plaintiffs. David Fleenor, general counsel for the cabinet, and Wes Butler, deputy general counsel, represented the cabinet in court.