ADA complaints filed against Texas and DC Medicaid

Posted on

March 12, 2024

Andy DiAntonio, Director of Communications
National Health Law Program
703-615-0786 (text for fastest response)

Lyndsay Niles, Managing Attorney
Disability Rights DC at University Legal Services
202-547-0198 x 128

DOJ and OCR complaints filed against Texas and DC Medicaid programs citing ADA violations

Washington, DC—Today, the National Health Law Program (NHeLP), together with Disability Rights DC at University Legal Services (DRDC) and Disability Rights Texas (DRTx), filed two separate complaints with the Department of Justice and the U.S. Department of Health and Human Services Office for Civil Rights alleging violations of the Americans with Disabilities Act (ADA) in the Medicaid renewal processes in both the Texas and the District of Columbia (DC).

While the complaints cite distinct issues, advocates in DC and Texas allege that the Medicaid programs have failed to provide equal access to coverage for people with disabilities and that they have not met their affirmative obligations to ensure the Medicaid renewal process would be inclusive of people with disabilities during the nationwide Medicaid coverage unwinding.

People with disabilities, especially those that are enrolled in Medicaid home and community-based waiver programs, are losing Medicaid coverage and services for which they are eligible that are critical to their health, safety, and community integration,” says Elizabeth Edwards, senior attorney at NHeLP. “Medicaid agency choices, including failures to adequately plan for equal access, are causing people with disabilities harm and must be halted until accessible policies and procedures are in place.”

The DC complaint (PDF) alleges that the Department of Health Care Finance (DHCF), the Medicaid agency for the District of Columbia, operates Medicaid renewal systems and processes that fail to provide equal access to Medicaid coverage, and that DC residents with long term care needs have been harmed by inaccessible systems that have made it difficult for them to maintain coverage.

The system for LTC enrollees does not support renewing independently, nor does it allow people to have assistance of their choosing. Instead District policy requires that LTC enrollees must rely on the unreliable assistance of Medicaid providers or case managers. These policies and practices are resulting in improper procedural terminations of Medicaid waiver personal care aide services and other Medicaid services that District residents need to live in the community, rather than nursing facilities. Additionally, the agency has failed to utilize existing information, forcing individuals to needlessly resubmit information, which adds barriers to remaining covered.

DHCF has long known that long-term care enrollees are losing coverage through no fault of their own, but because case managers that contract with the District are failing to complete  renewals timely and causing procedural denials,” says Lyndsay Niles, managing attorney at DRDC. “Coverage terminations must stop until DHCF revises its policies and procedures so that people with disabilities retain the coverage for which they are eligible.”

The Texas complaint (PDF) alleges that the State’s Medicaid fails to meet the needs of Medicaid enrollees who receive home and community-based services (HCBS) because the Texas renewal process does not utilize existing information to automatically renew peoples’ coverage, forcing them to go through administratively burdensome and inaccessible processes. Additionally, people who have had their coverage terminated must use a call center that provides incorrect information to people with disabilities, leading to people falsely believing they are ineligible or not appealing to protect critical services. .

Texans with disabilities face discriminatory barriers to keeping their coverage, and then face additional barriers when they try to address a wrongful termination,” says Maureen O’Connell at DRTx. “Until Texas Medicaid operates an accessible renewal process, no Texan enrolled in HCBS waiver services should have their critical services jeopardized by the dysfunction and inaccessible policies and practices of Texas Medicaid.

Read the DC complaint (PDF) and the Texas complaint (PDF).

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