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CHILD MEDICARE SUIT MAY PROCEED IN SOUTH CAROLINA

By Greg Piche'

Senior U.S. District Judge Malcolm Howard recently ruled that a motion to dismiss a class action brought by the defendants in McCartney v. Lanier Cansler, Secretary North Carolina Department of Health and Human Services, No 7:08-CV-57-H(3), must be denied. The plaintiffs claim that they were denied access to mental health and developmental disability benefits without a prompt hearing and that the defendant failed to adopt reasonable standards for implementation of its Medicaid program.  The three minor plaintiffs through their parents as next of kin brought the class action to restore the children?s rights prospectively. They are not suing form damages.

The court ruled that 11th Amendment immunity protecting states in federal courts did not apply because the complaint alleged an ongoing violation and the plaintiffs were not seeking damages for past wrongs. The court denied defendant?s request that it await the outcome of state administrative action pending on individual appeals because the federal interests in the issue outweighed the state?s and the federal court was not required to defer to the prior action of the state. The court noted recent case law that requires a state to provide Medicaid services with reasonable dispatch. See Doe v. Kidd, 501 F. 3d 348, 356. (4th Cir. 2007).  The court found of no moment that the state had delegated the administrative function for behavioral Medicaid services to a fiscal intermediary, which the plaintiffs allege were engaged in broad actions to restrict access to services because the state has the duty to assure that its agent complies with federal law.

As North Carolina's "single state agency," it is the duty of HHS, and defendant as Secretary of HHS, to ensure that North Carolina's Medicaid program is administered in compliance with federal law. HHS may not disclaim its responsibilities under federal law by simply contracting away its duties.

The court delayed the entry of a decision on class certification until the completion of discovery related to that certification. Now to find the money. Not an easy chore in these days of budget shortfalls.  

http://op.bna.com/hl.nsf/r?Open=psts-7qvrxd

 

Full post as published by Healthcare Law Blog on April 10, 2009 (boomark / email).